Membership update: On the quest for CDI opportunities for quality-focused reviews

There’s no doubt that focus in healthcare reimbursement shifted in the past decade—from payment for services rendered to payment methods which take the quality of those services into consideration.

About 41% of CDI programs currently review medical records for quality improvement items, according to an online ACDIS membership poll.

But buzzwords related to “healthcare quality” represent a wide-range of initiatives from an equally wide-range of agencies—from government and private insurers to private companies crunching data for public reporting.

Looking to expand program efforts into quality therefore, can prove daunting. It’s often helpful to hear from those who’ve delved into the process and have proved not only that it can work, but who can demonstrate how to adapt those focus areas to your own CDI programs.

That’s why ACDIS Advisory Board member Deanne Wilk, BSN, RN, CCDS, CCS, CDI manager at Penn State Hershey Medical Center brings along her team Marcy Miles, MT, (ASCP), MBA, manager of quality and process excellence, Melissa Macguire, RN, CDI educator, and Carol Houlihan, MHA, RHIA, quality informatics manager for a special ACDIS Live! webinar on Thursday, April 27.

In the program, Wilk will show how she and her CDI team moved from traditional CC/MCC capture to clinical support for severity of illness, to mortality reviews, to patient safety indicators, to readmission reduction and length of stay measures, to hospital acquired conditions and present on admission conditions, all the way to value-based purchasing items, core measures, and even bundled payments.

Before joining Wilk and her team on the extended webinar, do a little background research by reading through the March/April edition of the CDI Journal which includes a number of articles from a variety of industry experts on ways CDI record reviews for quality-focused initiatives can yield a host of positive results.

Even with the addition of quality measures, CDI should still concentrate on documenting an accurate picture of the patient’s episode of care. As Tamara Hicks, RN, BSN, MHA, CCS, CDS, ACM, director of clinical documentation excellence at Wake Forest Baptist Health in Winston-Salem, North Carolina, says in the article “Foray into CDI for value-based purchasing,” “It’s not all about the money; it’s about getting it right.”