Meet a Member: CDI gave her a way to use her pediatric expertise

Heather Pautz, BSN, RN, CCRN-K, CCDS, CDIP, is a CDI specialist at Children’s Wisconsin, and the secretary for the Wisconsin ACDIS local chapter. She has been in CDI for four years.

ACDIS: What did you do before entering CDI?

Pautz: I worked in the trauma/surgical pediatric ICU as a staff RN for five years and as a patient care supervisor for 10 years.

ACDIS: Why did you get into this line of work? 

Pautz: I wanted a change of pace from the rush of patient care and managing staffing and nurse onboarding in an ICU environment but wanted to continue to use my critical care and pediatric knowledge in a way that would continue to support the best and safest patient care. I had a strong desire to maintain a leadership position so when my organization began a CDI program in 2017, I jumped onboard as the supervisor for the fledgling program!

ACDIS: What has been your biggest challenge? 

Pautz: Learning all the CDI and coding regulations and incorporating that into our CDI program. We have a fabulous partnership with our hospital coders and meet regularly with them to share education and obtain coding advice—it is a very symbiotic relationship! Were it not for them and our two part-time CDI physician advisors, we would not have such an established program in just four short years!

ACDIS: What has been your biggest reward?

Pautz: Getting this program up and running. Together with the CDI specialists, coders, and CDI physician advisors we have created query templates, CDI tip cards, CDI tip sheets, a CDI program video, a CDI webpage, CDI policies and procedures, and have shared broad education with many provider groups and have had an excellent participation rate in our program in terms of query responses and agreement rates.

ACDIS: How has the field changed since you began working in CDI?

Pautz: The coding guidelines certainly change each October and that can have an impact on our program and focus areas annually. Being pediatric-focused we do not have as many resources readily available to us and must blaze our own trail but I have been able to network with other state ACDIS chapters and recently found the pediatric networking group on the ACDIS website, so I have joined that group as well. In the beginning, it felt like organizations did not want to share their work with others but now it seems we are opening ourselves up to collaboration which is so very appreciated. Additionally, now that we have identified the “low-hanging fruit” at our institution in terms of query opportunities, we are looking at innovations within our electronic health record platform that would enable providers to incorporate ICD-10 compliant documentation in real-time without the need for a CDI query. Collaboration with our IT department has been key in that process as well.

ACDIS: Can you mention a few of the “gold nuggets” of information you’ve received from colleagues on The Forum or through ACDIS?

Pautz: Contact information for other CDI personnel in similar fields and institutions—you are never truly alone!

I was able to get connected to my state ACDIS chapter and attend their conferences and meetings. I now volunteer as the secretary for Wisconsin ACDIS!

I tune in to the ACDIS Podcast regularly and reference past episodes as well.

The ACDIS Forum threads have also been a great resource when we have a CDI question as a starting point.

ACDIS: What piece of advice would you offer to a new CDI specialist?

Pautz: Be patient with yourself and learn as much as you can each day.

Don’t be afraid to ask questions and know that it will likely take about two years to feel confident and comfortable in this type of role.

No matter what your nursing or coding background was you CAN be an excellent CDI specialist for all populations. Openness to learning and maintaining a curious mindset are key!

Don’t be intimidated talking to the providers. If we approach them with solid information to back up our query collaboration can occur (giving them chocolate helps, too!).

ACDIS: If you could have any other job, what would it be?

Pautz: Travel agent. I bet they get sweet discounts and free stays to scope out vacation destinations! I would LOVE to travel the world and write reviews to help people plan their vacation time and recharge while having an awesome experience abroad.

ACDIS: What was your first job?

Pautz: My parents owned a popcorn business at the Summerfest grounds in Milwaukee. I spent many, many summers popping popcorn during all the festivals and maintaining the fourteen wagons we had with my family in the off season. Trust me, it only sounds glamorous to attend live music festivals all summer—popcorn wagons do NOT have air conditioning and are generally 15-20 degrees hotter than the ambient temperature!

ACDIS: Can you tell us about a few of your favorite things?

• Vacation spots: Ireland, Costa Rica, London, Paris, Rome, South Dakota, Mexico, “Up North” as we call it in Wisconsin (if you look on a Wisconsin map, “up north” generally refers to any are north of Fond Du Lac).
• Hobbies: Reading about history and also crime novels, Scouting with my sons.
• Non-alcoholic beverage: Hot Cinnamon Sunset Tea by Harney & Sons.
• Foods: Dark chocolate, Pad Thai, Mod pizza.
• Activities: Hiking and biking the Wisconsin State Parks and trails.

ACDIS: Tell us about your family and how you like to spend your time away from CDI.

Pautz: I am married and have two sons ages 12 and 13 and we have a black lab named Major whom the boys like to pheasant hunt with alongside their dad. I am an assistant scoutmaster for their Boy Scout Troop, and I volunteer quite a bit at the Council level for Scouting events and trainings. I have been the Secretary for Wisconsin ACDIS for the past year and enjoyed collaborating with the other board members on a virtual conference for our members which we hosted in October 2020. We will be meeting in January to plan out 2021 and we are eager to continue to provide our members with great education and engaging presentations.

ACDIS: Is there anything else you’d like to add?

Pautz: I obtained my CCDS certification on November 13, 2020, and my CDIP certification on November 16, 2020, and strongly encourage all CDI staff to pursue certification. I completed an AHIMA apprenticeship through my employer and the Department of Labor that prepared me for the CDIP exam and I utilized books thru ACDIS to prepare for the CCDS exam. Even though my scope is limited to pediatrics, I was able to pass both exams. Everyone can be successful if they put the time in to prepare—don’t wait, go for it!