Note from the ACDIS Editor: Help for your expanding CDI program

CDI Journal - Volume 14, Issue 1

by Linnea Archibald
One of the most fun things I get to do as the ACDIS editor is work with some of our committees—namely, the annual CDI Week planning committee and the Forms & Tools Library Committee. While the two committees have different scopes of work and focus, at their core, their mission is the same: to support CDI professionals, recognize their efforts, and help them advance their careers and their departments.

While I’ll share more about CDI Week (which takes place September 14–18) later in the year, I wanted to spend some time highlighting the work of the Forms & Tools Library Committee because their efforts can be especially helpful as we bid adieu to 2019.

The beginning of a new year often spells change and expansion for CDI programs. Whether 2020 holds an expansion to other service lines, a new setting, additional staffing, or job stratification, there are resources available on the ACDIS website and in the Resource Library to help—many due to the generosity of the ACDIS membership and the work of the Forms & Tools Library Committee.

The samples in the Library are donated by members of the ACDIS community and then reviewed for compliance and helpfulness by the Forms & Tools Library Committee. Each month, the committee meets to review any materials submitted in the previous month by answering the following questions:

  1. Is the sample compliant? If not, in what way?
  2. Is the sample helpful? Why or why not?
  3. Would you recommend the sample for publication? Why or why not?
  4. What revisions are necessary?

During the meeting, the committee formulates specific recommendations and advice to accompany each posted resource. This means that those pulling resources from the Library not only get a sample form to use in developing their own tools, but they also know that the sample has been vetted and can read any accompanying recommendations from the committee, which comprises CDI professionals from a variety of backgrounds and experiences.

So, how can ACDIS members leverage these resources for all their worth? Let’s look at programmatic expansion opportunities to see how the materials within the Resource Library can help.

Outpatient CDI
If 2020 holds an outpatient expansion for your CDI program, there are a number of resources available to help you get off the ground smoothly. First, you’ll need to establish a vision for staffing and responsibilities. Take a look at the sample outpatient CDI job descriptions donated to the Library by Tamara Hicks, RN, BSN, MHA, CCS, CCDS, ACM, the director of clinical documentation excellence at Wake Forest Baptist Health in Winston-Salem, North Carolina.

Even if your program specifics vary from hers, you can still leverage Hicks’ manager and staff job descriptions to shape your own, adapting them for your focus and needs. To get a fuller picture of the scope and differences of outpatient programs at different organizations, also take a look at the ambulatory CDI specialist job description provided by Yvonne Whitley, RN, BSN, CRCC, CPC, CRC, the supervisor of ambulatory CDI at Novant Health Medical Group in Charlotte, North Carolina.

Training your brand-new staff for a brand-new program can present some serious challenges. While new staff on the inpatient side can shadow mature staff members until they get up to speed, outpatient CDI newbies are starting from scratch. Coming again from the folks at Wake Forest, the Library also houses a sample outpatient staff orientation plan, breaking down weeks 1 through 12 for a new CDI professional. To go along with the orientation plan, there’s also an onboarding timeline in the Library so you can track your new team members’ progress as they get their feet under them.

As you bring new staff on board and begin to launch the new outpatient program, you’ll also need to develop a workflow. Luckily, there’s a sample process for outpatient reviews in the Library, also provided by Hicks. To ensure staff members adhere to the workflow and any productivity metrics set forth by program leadership, Valerie Parent, RN, BSN, CCDS, CCRN-K, the CDI manager at Eastern Maine Medical Center in Bangor, contributed a record review tracking tool and a monthly tracking tool for outpatient use.

Pediatric CDI
Outpatient CDI isn’t the only expansion area covered by the Resource Library. Whether you’re starting a CDI program at a stand-alone children’s hospital or expanding reviews to the pediatric unit in your facility, there are resources available. While pediatric CDI leaders may be able to adapt a standard inpatient acute care CDI specialist job description to suit the needs of the pediatric space and the programmatic structure may be largely the same, pediatric patients are completely different from a clinical standpoint, so you’ll need to develop unique query forms for this setting.

Recently, the Forms & Tools Library Committee received and reviewed several neonatal queries submitted by Erica Braun, MS, BSN, RN, CCDS, manager of inpatient coding and CDI at Nebraska Methodist Health System in Omaha, that may be helpful in your pediatric expansion efforts:

The Committee is also currently reviewing several other pediatric and neonatal submissions; stay tuned for additional samples soon.

Job title stratification
Maybe your program expansion isn’t based on the settings you review, but rather on the job titles represented in your department. If that’s the case, we have resources for you, too. One popular addition for mature programs is the role of CDI data specialist or analyst. As CDI departments get involved with more initiatives, the data pool grows ever larger and more complex. Opting to employ a CDI staff member specifically with the purpose of data analysis and management can help a program measure their outcomes and identify new areas for potential expansion down the line.

Those looking to add an analyst to their staff have three sample job descriptions to review: one from Robin Jones, RN, BSN, MHA/Ed, CCDS, regional director of CDI, West Florida Division, at AdventHealth in Tampa, one from Deanne Wilk, BSN, RN, CCDS, manager of CDI at Penn State Health in Hershey, and one from Tonya Motsinger, MBA, BSN, RN, system director of CDI at OhioHealth in Columbus.

Programs looking to enhance physician engagement may also be looking to add a physician advisor to their team in 2020. According to our survey published in the May/June 2019 edition of the Journal, 36% of respondents with a physician advisor said that their physicians were very or extremely engaged (compared to 28% of those without an advisor who said the same). If you’d like to take advantage of that engagement boost, take a look at our sample physician advisor job description from the CDI Companion for Physician Advisors: Notes From the Field by Trey La Charité, MD, FACP, SFHM, CCDS, available in the Library.

The Library also holds a sample CDI educator job description contributed by Lee Ann Landon, BSN, CCMC, CCDS, CDI manager at Honor-Health in Scottsdale, Arizona, and a second-level reviewer job description from Diane Kohler, RN, CCDS, manager of the CDI department at Centura Health in Centennial, Colorado. Both positions can help your department deepen its work and standardize processes for smooth sailing in 2020.

While I’ve covered many of the new additions to the Resource Library, this article is far from exhaustive. Over the past year, the Forms & Tools Library Committee has reviewed dozens upon dozens of samples, adding them to the Library with best practice recommendations. Next time you’re looking to advance your program, update a policy, or develop a new tool, make sure to check in at the Library. You never know what you may find.

Editor’s note: Archibald is the editor for ACDIS. If you’d like to write for an ACDIS publication or be featured in an article, need help locating resources on a particular topic, or want to submit a sample to the Resource Library, contact her at larchibald@acdis.org. If you’d like to volunteer for an ACDIS board or committee, please review the January call for volunteers and submit an application here.

Found in Categories: 
ACDIS Guidance, CDI Expansion