Guest Post: Look beyond query numbers for program assessment

by Sylvia Hoffman, RN

The case mix index is up and admissions continue to rise. You’d think this was wonderful news. Yet, the facility administration  complains that reviews are down and queries are low. You don’t have to be a math genius to know that something here does not compute.

Is the education given to physicians and allied health professionals being evaluated? Does anyone evaluate the improvement in documentation?

Numbers are classically low in the summer months in Florida due to the absence of our much loved snowbirds from Canada. Vacations from both CDI professionals and physicians take a toll on productivity. New residents start in July, and the heat index rises to 98 degrees (and I don’t mean the literal temperature, either).

Help! How do you rate the success of your clinical documentation department?

Query response rates are evaluated and the overall numbers of reviews are counted. The revenue elicited from these queries is tallied and viola, the success of a program is in the financial numbers. Wrong!

CDI specialists spend a good deal of their day speaking to physicians and educating them on the benefits of proper documentation. They attend huddles with case management, they are members of committees, they round with specialty teams, and they frequently make presentations at meetings and resident Grand Rounds. Does this not count for anything? There needs to be a better way to evaluate success.

CDI presentations commonly extol the virtues of proper documentation— how it improves mortality and morbidity scores and severity of illness statistics. Physician “buy-in” is stressed at every turn, but where and when do we get to discuss the importance of the hospital administration’s “buy-in?”

Editor's note: Hoffman, at the time of this article's release, was a CDIS in Tampa Florida. She has been a nurse for more than 20 years and enjoys writing, painting, and travelling.