Meet a Member: ‘Be kind to yourself and be patient’

March 17, 2022

CDI Strategies - Volume 16, Issue 11

Keisha Downes, BSN, RN, CCDS, CCS, is the CDI director at Tufts Medicine in Boston. She is a member of the Massachusetts ACDIS local chapter volunteer leadership team and the CDI Leadership Council. She is currently serving on the ACDIS Furthering Education Committee.

ACDIS: How long have you been in the CDI field, and what did you do before entering the field?

Downes: I’ve been in CDI since 2013. Before that, I had an eclectic background. I worked in the stepdown unit, neurosurgical ICU, trauma ICU, as a charge nurse in ICU at Naval Hospital, and in interventional radiology.

ACDIS: Why did you get into this line of work?

Downes: By accident. I attended a job fair in hopes of interviewing to be an operating room nurse. The CDI team had a table at the job fair. It seemed so interesting, so I applied on the spot.

ACDIS: What has been your biggest challenge?

Downes: The biggest challenge has been staying up to date with the recent COVID diagnosis and coding rule updates. As there is more exposure and understanding of COVID, I am sure that this will continue to be a focus in upcoming Coding Clinics and Guideline updates.

ACDIS: What has been your biggest reward?

Downes: I am in a position where I am able to educate providers and new staff to all aspects of documentation integrity. The moment when a new CDI specialist or a provider “gets it,” when they truly understand a concept or the overarching importance of what we do, that is so rewarding. I recall when my own lightbulb went off and I am happy that I am able to play a key role in others understanding CDI.

ACDIS: How has the field changed since you began working in CDI?

Downes: The field has been ever changing. The original focus was to optimize the DRG with a CC or MCC. Now, we have expanded our reach to collaborations with quality for focus on patient safety indicators and mortalities, are included in multidisciplinary rounds, and are exploring the outpatient realm.

ACDIS: Can you mention a few of the “gold nuggets” of information you’ve received from colleagues on The Forum or through ACDIS?

Downes: I always grab gold nuggets when I network with CDI specialists via ACDIS. The local chapter meetings have given insight on query opportunities that were not on my radar, the ACDIS conferences help me network with CDI specialists across the nation and understand what challenges that they face with denials prevention, and the ACDIS Leadership Council has put me in touch with other leaders in the field that helped understand software challenges, managing in a fully remote setting, and ideas for keeping the team engaged.

ACDIS: If you have attended, how many ACDIS conferences have you been to? What are your favorite memories?

Downes: I was able to attend ACDIS conferences in Las Vegas, San Antonio, and the Outpatient Symposium in Oak Brook, Illinois. While San Antonio was beautiful, I enjoyed the Outpatient Symposium the best. There was so much for me to learn about this new frontier.

ACDIS: What piece of advice would you offer to a new CDI specialist?

Downes: Be kind to yourself and be patient. Many new CDI specialists were an expert in their prior role so it may feel very uncomfortable being a novice again. It may feel overwhelming to have so many questions and feeling like the “weakest link.” We have all been there, do not give up. Learn all that you can, and await your light bulb moment. It will come!

ACDIS: If you could have any other job, what would it be?

Downes: I think I missed my calling to be a professional traveler. I would love to be paid to fly around the world and experience different people, food, and cultures.

ACDIS: What was your first job?