Guest Post: Thoughts on evaluating vendors/consultants

by Donald A. Butler

A CDI Talk string discussed ideas for evaluating consultants—a conversation that didn’t gather much steam. So I thought I would throw some ideas out to CDI “blog-o-sphere” to discover what floats.

When considering whether to enter into a contract with a vendor or consulting firm, first determine if this particular entity’s culture and philosophy “matches” that of your own organization. Second, determine what services, products, and/or deliverables you need the consultant to provide. Third, do some legwork to obtain both direct and indirect referrals regarding the consultant’s performance. Be sure to contact referrals provided by the consultant and also gather others on your own through networking or by contacting facilities of similar size and make-up as yours.

Compatibility

You will likely be able to answer the first question, whether your philosophy the consulting firm’s philosophy match, only after several interactions between yourself and representatives from the consulting company, and by combining a number of sources. From my viewpoint, it is a crucial question but ultimately one that each program/organization really needs to answer for itself.

Of course, understanding whether your program is compatible with the philosophy/goals of the consultant also depends on whether you and your program staff have a solid understanding of trends in the CDI profession. Your CDI team and manager must possess a working knowledge of commonly accepted best practices and overall trends of CDI practice from a national perspective.

Frequently, facility leaders hire a firm to provide their facility with that level of insight. Of course, consultants travel the country working with diverse program types and sizes and can provide such overarching global perspective. However, comparing their perspective against your own awareness can foster interesting dialogues regarding program goals and parameters. From that position of self- and industry-knowledge, you (as the hiring agent) can consciously develop your own thoughts and positions and compare them against the particular consulting firm’s’s vision. Hmmm, already quite a bit of hard thought and work!

Products and services

Evaluate your CDI program and its interactions with other, related departments, to determine exactly what product and services you need.

Perhaps when you attended last year’s ACDIS National Conference, you saw a great demonstration of a new query software package. After further discussion, management at your facility wants to move forward with discussions regarding it and other similar products. As it turns out the vendor or consulting firm you remember from the conference not only provides a CDI-related query tool but other products and services as well. What should you do?

Again be aware of the scope and particulars of your facility’s needs. Then, ask different vendors a lot of questions. Keep a spreadsheet of the questions you’ve asked, how each vendor responded, and which vendor representative answered which question on what date.

Determine what tools or products will be provided (and whether the contract include periodic updates to these) such as:

• Hardware, software, or system integration
• Sample queries, policies, and procedures
• Physician education pocket cards, handouts, PowerPoint presentations, educational materials
• Reference books and additional education
• On-call services
• Periodic auditing
• Regular systems analysis and reporting
• Ongoing staff training

Once you’ve worked out the details of the services and products the consulting firm will provide, dig a little deeper to determine the scope and range of education the vendor will provide to your staff. After all it does no one any good to have a great gadget if no one knows how to use it. Ask:

• Will the vendor provide training to coders, CDI staff, physicians, and upper management individually?
• Will it tailor sessions to the needs of individual groups/departments?
• Will it guarantee the qualifications and expertise of its instructors? If your staff desires the specific qualifications of a particular individual to train your physicians be sure to include that in the contract.
• Will the organization gain the rights to the education materials or does the consulting firm retain them? Once the contract concludes will the facility need to develop its own educational program or query forms)?
• What forms of ongoing support and education will the vendor offer in the first few months and years?

Additionally, create a plan to evaluate the vendor’s effectiveness. Develop an implementation timeline and set reasonable deadlines for deliverables.

References

As I mentioned earlier, vendors/consultants should freely offer names of referrals of people and programs with which they have a positive working relationship. Be aware, of course, that these sources will most likely express glowing recommendations of the company with whom they are contracted. That’s to be expected. Everyone wants to put their best face forward. You wouldn’t tell a prospective employer to call an old boss with whom you’ve had an unresolved dispute, would you? Therefore, be sure to target your questions to these references to get the most well-rounded description of their experience. Ask:

• What was the highlight of your experience with this consultant/vendor?
• What part of the process would you do over differently? Why? And be sure to ask the individual how he or she would change his or her own behavior. What parts of the process do you wish the consultant/vendor would have handled differently? Why?

Armed with information and background from this exchange, solicit feedback from other peers to augment your research with an unbiased assessment. You may struggle to find a similar facility that also has experience with a given vendor. Use the networking available via ACDIS (e.g., local chapter members and meetings, ACDIS social media, and message boards). Also reach out to nearby facilities to see if they’d host you for an afternoon to give you a better picture of how they use the vendor/consultant product and services on a daily basis. These questions will likely be helpful even if your neighbors and peers have experience with different consultants. You can certainly learn broader lessons. Be sure to ask:

• How long have you worked with this vendor/consultant?
• Can you rate your overall experience on a scale of 1-10 (10 being the best)?
• What duties did the vendor/consultant include in your contract?
• What did the vendor/consultant do to understand your organization’s dynamics, culture, unique factors, etc.? What adjustments did it make to its proposal in light of that understanding?
• What was its strengths?
• What was its weaknesses?
• What tools did the vendor/consultant provide and how would you evaluate those tools (e.g., electronic programming, handouts and reference materials, educational sessions, manuals)?
• What level of ongoing support does the vendor/consultant provide?
• What type of data analysis or reporting did the vendor/consultant provide?
• What were the tangible and concrete results of the engagement?
• If you were to start over again, what aspects of the project or of the consultant engagement would you handle differently? Why?
• Going forward, what would you ask the vendor/consultant to change, add, stop, or maintain?

Final thoughts

Good consultants/vendors are experts who bring value to your organization. Don’t hesitate to ask questions, to tailor their offerings to your facility’s needs, or to try something a bit different, something your facility thinks might work better locally. Similarly, don’t hesitate to decide not to follow a particular piece of advice. Of course, proceed carefully, thoughtfully, and with discussion, but still, don’t hesitate to try!

At the end of the day, it is up to you and your organization to carry your CDI program forward so you need to be clear on what, why, and how you and your team plans to do things and be comfortable with that.

Editor's note: Butler entered the nursing profession in 1993, and served 11 years with the US Navy Nurse Corps in a wide variety of settings and experiences. Since CDI program implementation in 2006, he has (at the time of this article's original release) served as the Clinical Documentation Improvement Manager at Vidant Medical Center (an 860 bed tertiary medical center serving the 29 counties of Eastern North Carolina).