Note from the instructor: Reminiscing over 10 years in CDI

By Sharme Brodie, RN, CCDS

One of the wonderful things that time allows us is the ability to look back with an experienced eye and either learn from the past or at the very least have some fun with it.

I remember my first weeks as a CDI specialist as if it just happened. It was a  grueling hiring process and I was thrilled to have gotten the job. Looking back, I have no idea why I thought this would be a good step in my career. None of us knew at that time what we were doing and we had no idea what to expect from this new profession.

We spent our first couple of weeks in conference rooms highlighting the newest version of the DRG Expert and making notes on every header, footer, and margin available on each page—and it was a big book. Back 10 years ago not every CDI specialist had access to an encoder so we looked diagnosis up manually. This should have been enough to send me back to the bedside but, for some reason, I decided to stick it out. 

Imagine if we still had to do things manually without the assistance of an encoder and all the bells and whistles that are built in. I’m not sure with the latest version of the DRG Expert consisting of two volumes with more than 1,000 pages that we could do it. We would probably all run.

We spent a lot of time making decisions, we thought were extremely important, including what color of paper would be used for our queries. Believe it or not, we spent a whole week looking at different shades of gold (we ended up deciding on “goldenrod yellow,” by the way). I can’t tell you what color paint I have been staring at for the past 10 years in my own bedroom, but I remember those query sheets of goldenrod yellow.

Between trying to decide where in the medical record to put these queries and how to notify the physicians they were in the chart, and explain how they were supposed to answer them, I am honestly surprised we accomplished any work. We debated CDI staff productivity standards, asking ourselves how much time we needed for computer-based record review and personal education and how much time we needed to spend on the nursing units making ourselves visible and available to physicians.

Now, encoders are the norm for even new CDI specialist, and EHRs have made reviewing a patient’s chart much easier with many CDI departments being remote. 

In my early days in the role, we suffered sleepless nights worried over what would happen once we educated all the staff at our facilities and our queries were no longer needed. Clearly, this was not a concern to lose sleep over.

If nothing else, the past 10 years have brought us closer to the realization that the position of a CDI specialist is extremely important not only for the CDI specialist and coders, but to many of the personnel working in numerous departments that make up a facility. It recently has also become very clear that this position is like an octopus with many long reaching arms into quality, medical necessity, outpatient, and further. As we move forward, we will find ourselves in many areas that 10 years ago were not even thought of. So, here’s to 10 years more in CDI—whatever they may bring!

Editor’s Note: Brodie is a CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts. For information, contact her at sbrodie@hcpro.com. For information regarding CDI Boot Camps offered by HCPro, visit www.hcprobootcamps.com/courses/10040/overview.