Every year, ACDIS celebrates clinical documentation specialists with a full week of activities, education, and fun. This year’s CDI Week theme is ACDIS Cinema—CDI: Coming to an Organization Near You, which aims to bring CDI professionals from behind the scenes and into the limelight, recognizing them for the superstars they are.

Leading up to CDI Week, ACDIS releases a survey giving insight on the state of the CDI industry. This year’s survey included questions about physician engagement, key performance indicators (KPI), quality reviews, outpatient CDI, and denials management.

“These survey results provide a true window into the day-to-day life of our profession,” says Aimee Van Balen, RN, BNS, CCDS, lead clinical documentation specialist at Lifespan Corporate Services in Providence, Rhode Island, and this year’s CDI Week Advisor.

This year’s survey garnered a whopping 849 respondents, up more than 200 respondents from last year’s 639. Although this report will not discuss every survey question in detail, readers can examine all the responses beginning on p. 11.

Survey respondents represented different positions and titles within the field, with CDI specialists the most common at 49.82%, up only 1% from last year’s count. Following behind were CDI managers at 14.72% and CDI directors at 10.6%. Just shy of 4% of respondents were CDI supervisors, 3.3% were CDI leads, and 2.71% were educators. The survey also contained options for more specific positions, such as CDI-coding liaison or physician advisor, though fewer respondents selected those options. (See Figure 1.) Most respondents (85.28%) work in traditional acute care hospitals. (See Figure 2.)

The largest portion of respondents (15.19%) work in facilities with more than 1,000 beds; organizations with 201–300 beds and 301–400 beds were nearly tied, with 12.25% and 12.49% respectively. (See Figure 3.) This varies drastically from last year’s results where most respondents (16.59%) worked in organizations with 201–300 beds, and only 9.39% had more than 1,000 beds.

This year’s survey also asked those who work at health systems about their organization’s size. It found that most who work in a health system (26.32%) work for one with more than 3,000 beds, followed by 17.85% working in systems with 1,001–1,500 beds and 14.07% in systems with 500 or fewer beds. (See Figure 4.)

As with past years’ Industry Surveys, the 2020 edition also had respondents from various experience levels. The most represented group was CDI professionals with between three and five years of experience (23.32%), followed very closely by those with six to eight years of experience (22.5%). Next, coming neck-and-neck, were 15.55% of respondents with between zero and two years of experience, and 15.43% with between 11 and 15 years of experience. Those with nine to 10 years of experience made up 10.13% of respondents, 7.77% had over 20 years of experience, and 5.3% had between 16 and 20 years of experience. (See Figure 5.)

“When I first started my CDI career 11 years ago, I was very concerned to leave the bedside and worried that this profession may not have been a long-lasting career choice. I am so grateful that my concerns were unwarranted,” says Van Balen. “I do think that the length of CDI careers also speaks to the dedication of our profession. ACDIS is filled with so many dedicated CDI and coding professionals who pour their hearts and souls into their work each and every day.”

As for credentialing, the majority of respondents (75.74%) hold an RN license. The next most common credential was Certified Clinical Documentation Specialist (CCDS) (59.48%), followed by Certified Coding Specialist (CCS) (14.72%). It’s important to note that many CDI specialists hold more than one credential, and 28.74% of respondents wrote in additional credentials not listed as survey options. (See Figure 6.)

“Having worked in CDI for a long time now, it no longer surprises me that the overwhelming majority come from an RN background, but I was happy to see many coding backgrounds as well. I do think many people are capable of holding a CDI title, not just nurses, so I hope that we continue to see more integration with other backgrounds,” Van Balen says.

For reporting structures, 38.52% of respondents said their CDI departments report to the HIM/coding department. Following that, 13.07% report to the quality department, and only 11.43% of respondents have a stand-alone CDI department. (See Figure 7.)

Continuing a trend begun in years past, this year’s survey showed CDI programs’ further diversification into other areas of healthcare beyond traditional inpatient acute care reviews, such as outpatient services and denials management.