Guest Post: Extend CDI education to all ancillary staff members

By Laurie L. Prescott RN, MSN, CCDS

Did you understand the CDI role before you took the job?

When I began and introduced myself to staff throughout the hospital, I can honestly say I did not explain my role really well. To be honest, I was unsure exactly what my role encompassed. Now, almost six years later, I smile when I am introduced to new staff and the nurses say “This is Laurie…she reviews the charts” or “she keeps the doctors in check” or “she makes us money…”  Beneath my smile though, I cringe a bit. Our role is so much more than that.

I recently had the opportunity to teach a class to all the nursing staff. The content included some requests from our coders to include information on patient status (inpatient vs. observation), such as how we charge for services, the importance of start/end times, clear orders etc. We discussed how DRGs are determined, relative weights, severity of illness, geometric mean length of stay (GMLO) and reimbursement. We discussed how secondary diagnoses influence DRGs with CCs and MCCs.

I was surprised by their interest and desire to learn more. Over the years I had attended unit staff meetings, morning huddles. I had written information fliers and invited them to come shadow me. I find the more they know, the more they can support my efforts. They now understand the importance of their assessments in determining present on admission (POA) and in issues like aspiration pneumonia, functional quadriplegia, wound staging, etc.

The dieticians have worked closely with us as a result of early education on the importance of documentation of clinical assessments for malnutrition. We have used their expertise to appeal denials relating to malnutrition and as a result their documentation has improved greatly. And their improved documentation has influenced better documentation by the medical staff.

Unit secretaries, clerks, and nurse aides are great resources of information for us. Do not forget them in your education efforts. I have even heard a unit clerk tell a physician, “Laurie has a question for you on the chart…be sure to answer it.”

Knowledge is power. And developing a support network that understands our mission and can articulate it to others can only make our efforts stronger. So, while you’ve have time to hone it over the years, even new CDI specialists should have a “five minute speech” ready to describe CDI and how your efforts help to create a complete and accurate medical record for the patient. Personalize your education to the person or role and offer them examples of how they help you every day. And let them know you appreciate their help.

What resources have you found in your organization? And how have you fostered them?

Editor’s Note: Prescott, at the time of this article's original release, was a CDI specialist at Morehead Memorial Hospital in Eden, N.C. She has more than 25-years’ worth of nursing experience having received her BSN from the University of Vermont and her MSN-ed from the University of Phoenix. She has worked in many aspects of nursing to include med-surg, peri-anesthesia, ICU, nursing administration and nursing education, and began working as a a CDI specialist in 2007.