Conference conversations: Understanding pediatric brain disorders

CDI Blog - Volume 12, Issue 52


Marietta Morhardt, RN,
BSN, CPN, CCM


Pam McCall, BSN,
RN, CCM, CPN

Editor’s note: Marietta Morhardt, RN, BSN, CPN, CCM, and Pam McCall, BSN, RN, CCM, CPN, will present “The Pediatric Altered Brain,” on Day 2 of the ACDIS conference. Morhardt and McCall are CDI specialists at Children’s Hospital and Medical Center in Omaha, Nebraska. This year’s conference takes place May 20-23 at the Gaylord Palms Resort & Convention Center in Kissimmee, Florida.

ACDIS Blog: What’s one common documentation opportunity with pediatric brain disorders? What should CDI professionals look for?
Morhardt and McCall: A big one that gets missed a lot is “intellectual disability.” While it might not change your DRG or increase the severity of illness (SOI)/risk of mortality (ROM), it will speak to the complexity and resources required to care for the patient, and also be relevant for the family when seeking support outside of the hospital.

ACDIS Blog: How do you suggest CDI professionals educate physicians on proper documentation for these charts?
Morhardt and McCall: Show physicians how the documentation makes a difference in the relative weight and SOI/ROM. Remind them that the more accurate the description of the patient, the more resources can be available to care for these complex kids. Utilizing your physician advisor (if you are lucky enough to have one) to speak to them is also very beneficial, as most physicians—even in the pediatric setting—prefer peer-to-peer clinical conversations about CDI efforts.

ACDIS Blog: In your experience, what’s been the hardest part about reviewing theses records?
Morhardt and McCall: Making sure you don’t miss any details. Some diagnoses can be placed in unusual places in the medical record. There’s a lot of extemporaneous information to sort through and we also have to be wary of the dreaded cut and paste problem. However, I’m so thankful we have an EHR now; having to comb through paper charts would be so tedious.

ACDIS Blog: What’s one thing attendees can expect to come away with from your session?
Morhardt and McCall: I hope they glean  some little nuggets of information they weren’t previously aware of, as we found out in putting this presentation together. There are some Coding Clinic references included, and some anatomy and physiology concerns that we hadn’t thought about for a long time.

ACDIS Blog: In what ways does your session challenge CDI professionals to think outside the box?
Morhardt and McCall: One thing is to look for is key words or descriptions of a patient and their condition that will trigger you to send a query, and realize that pediatric patients aren’t just “little adults.” There really is a difference.

ACDIS Blog: What are you most excited for about this year’s conference?
Morhardt: Seeing a few familiar faces from previous conferences. I had to miss last year due to lack of funding, so am anxious to gain new insights this year.

McCall: I’m looking forward to the whole experience. It will be my first time attending.

ACDIS Blog: What’s your favorite ice cream flavor?
Morhardt: I am not a huge fan of ice cream itself, but rather what is in the ice cream, but anything chocolate with chocolate chunks wouldn’t be passed up.

McCall: My favorite is chocolate chip.