Note from the speakers: Advice for CDI professionals at the conference and at home

Leading up to the 2019 ACDIS conference, the ACDIS editorial team caught up with many of the speakers who will be sharing their experiences at the podium this week. While attendees will receive a wealth of helpful information by being at the event, the ACDIS team wanted to share some of our speakers’ advice that will help even those who are staying at home, manning the trenches of record reviews.

Though we’ve pulled together some of our speakers’ top advice, there’s still much more to be found on the ACDIS website, including advice for working with multiple sepsis definitions, new malnutrition criteria, reviewing records from the burn unit, collaborating with quality, and much more. To see a full list, click here.

Advice for physician engagement

Physician engagement is a constant problem area for CDI professionals, no matter their experience level. To shed some light on the issue, Judy Cassetty, BSN, RN, CCDS, and Brian Cui, RHIA, CDIP, will join forces on Day 3 of the conference to share their best practices for communicating with, and educating, physicians.

Though there are many methods CDI teams employ for physician education, Cassetty said on the ACDIS Blog that “relating to the audience and their day-to-day experiences is a must. […] It is not always just what you say, but how you say it.”

Effective physician engagement and education relies just as much on the method of communication as it does on the information relayed, Cassetty says, which is why her session will discuss both verbal and non-verbal communication tactics. Cassetty says that CDI specialists also need to be flexible with where and when they provide education, tailoring it to the particular situation and physician. While participating in discharge rounds may work for some physicians, others may prefer an informal meet and greet in the doctors’ lounge. Again, CDI professionals need to know their audience.

“The hard work of any CDI professional does certainly involve engaging physicians,” she says. “Providing conference attendees with real-life situations and tips for physician engagement can help relieve some of their stress related to the face-to-face or phone conversations they need to have with physicians for query and education purposes.”

Advice for collaboration

It can be easy to get trapped in a silo in any job, but add in productivity expectations, writing queries, and educating physicians, and a CDI professional can easily find themselves isolated in their day-to-day roles.

“The biggest risk [to having CDI as a silo] is that you will not get buy in from anyone and everyday will seem like you are trying to climb Mt. Everest,” said Megan Cortazzo, MD, who will be presenting on Day 2 of the conference on the topic of collaboration.

Often, Cortazzo said, when a rift between departments—for example, CDI and coding—has arisen, the best starting point is to address the issue head-on. “If you know the reason for the poor relationship, and it can be addressed up-front, I highly recommend that,” she said. If the reason behind the rift remains unclear, find the common ground, she said.

“Although initially it may be perceived as extra work, outside your zone, or just plain old daunting, the rewards [of collaboration] are numerous,” Cortazzo said. “Relationships help build an organization and building those relationships across your organization only enhances the overall work environment and the mission of the organization.”

Advice for program revitalization

While many CDI teams have just a couple years of experience, more mature programs need to fight the tendency to fall into a programmatic rut, according to Robin Jones, RN, BSN, MHA/Ed, CCDS, and Kimberly Higgins, RN, BSN, CCDS, who will present on Day 1.

The slide may be gradual, but there are several tell-tale signs CDI leaders should be wary of. “Leaders need to watch for decreased enthusiasm, decreased metrics, and ancillary departments not knowing about the CDI program,” said Jones. “If staff and stakeholders don’t understand the importance of the role, they won’t support efforts and won’t feel empowered by the job they perform every day.”

If the signs are present, CDI leaders should do everything in their power to energize the team and breath life back into the CDI program. The key to halting the slide, according to Jones, is employee engagement.

Leaders should take the time to listen to their CDI team members, to their concerns and complaints, and thoughtfully address them through program changes. This will ensure a healthy program in the long run, she said.

“Leaders need to work with their HR departments on a career ladder, incentive plan, or allow associates a better work-life balance in the ability to work remotely either a set number of days per year or through a hybrid program,” Jones said. “These measures can fuel excitement and show front line associates [CDI specialists] that leadership wants to invest in them.”

Advice for program expansion                                        

After more than a decade of hard work and well-earned results, organizations are increasingly asking CDI programs to expand to new review areas, special projects, and more, taking their success beyond inpatient reviews. Because of this, the ACDIS conference boasts two tracks focused on reviews outside of the inpatient setting—Track 4: Expansion & Innovation and Track 6: Outpatient & Pediatric.

Before a expanding, a CDI program should get all their metaphorical ducks in a row when it comes to inpatient reviews, according to Day 3 speaker Nicole Fox, MD, MPH, CPE. CDI leaders should “ensure they have a firm handle on their current CDI program,” she said. “After they have mastered the ‘bread and butter’ inpatient chart review, [CDI programs] need to be actively identifying ways to remain relevant and areas to expand into.” 

Fox also suggests organizations choose just one expansion area at a time to ensure they can gain the leadership and physician buy-in and keep the CDI team from being stretched too thin. “It is easy to lose the providers if you expand too quickly and/or into the wrong areas that are not relevant for your organization,” she said.

Choosing a focus, of course, is easier said than done. In addition to internal research through auditing, etc., Fox encourages CDI leaders to do some digging outside their organizations.

“Read the ACDIS website, white papers, and additional materials such as the annual CDI Week Industry Survey Report as a guide and decide on ONE area at their institution they can expand to successfully,” said Fox.