Q&A: Making the most of limited medical staff education

CDI Strategies - Volume 12, Issue 18

Q: Recently I’ve been given the opportunity to present CDI concepts at the quarterly medical staff meetings. They have given me 10 minutes each quarter to teach a topic. I am excited, but it also feels a bit daunting. How I can make a difference in four 10-minute sessions a year? Any words of guidance?

A: Great question. I do believe that with some creativity, identification of key topics, and concise, pointed educational materials, you can certainly have an effect. This is a difficult group to teach as time is of the essence. Historically, these types of meetings have had agendas that are packed full. I would suggest you ask to present  early in any educational agenda versus at the end.

You only have four meetings in the year, so my thought is that you should keep this education basic. Don’t try to go too in depth as you will not be able cover much in only 10 minutes. Also, you cannot guarantee that the audience will be the same from meeting to meeting. Work with your peers to find four concepts to teach. Always verify your education is correct and provide handouts to reinforce your presentation. Some suggestions might be:

  • How documentation influences length of stay
  • How documentation influences observed-to-expected complications or mortality
  • Documentation of complications
  • How documentation influences risk adjustment
  • Tips and tools of quality documentation (focus on two or three specific documentation issues)

I often used side-by-side examples when teaching my providers. On the left side, I give them an example of poor documentation with a summary of relative weights, severity of illness (SOI)/risk of mortality (ROM), risk score, etc. On the right side, I provide documentation of the same encounter using quality documentation with the same information. You can point out how the example on the right influences the numbers positively, as well as note the queries that would have been sent regarding the documentation on the left side. I find that providers respond really well to such examples as the two below:

“HCAP Pneumonia”

Pseudomonas pneumonia”

DRG Grouping 193, 194, or 195

  • Length of stay 2.8-4.6 days
  • Average reimbursement: $3,795-$7,484
  • SOI: 2
  • ROM: 2
  • No value added to the risk score

DRG Grouping 177, 178, or 179

  • Length of stay 3.5-5.9 days
  • Average reimbursement: $5,305-$10,082
  • SOI: 2
  • ROM: 2
  • 0.599 added to the risk score

 

“COPD exacerbation, end stage lung disease, malnutrition”

“COPD exacerbation, chronic respiratory failure, severe protein calorie malnutrition”

DRG Grouping 191

  • Length of stay 3.3 days
  • Average reimbursement: $4,959
  • SOI: 2
  • ROM: 1
  • 0.873 added to the risk score

DRG Grouping 190

  • Length of stay 3.9 days
  • Average reimbursement: $6,119
  • SOI: 3
  • ROM: 2
  • 1.175 added to the risk score

 

My second piece of advice is to subscribe to the philosophy of the children’s book, If You give a Mouse a Cookie. (Read it, if you never have; it was one of my daughter’s favorites.) The point of the book is that the mouse always wants something more. So, if you have been given 10 minutes four times a year, perhaps ask if you could attend meetings of the specific sub-specialties. For example, how great would it be to speak to the surgical staff alone, or the oncology staff, etc.? Can you attend monthly hospitalists meetings? Also, if your medical staff produces a monthly newsletter, ask to write a monthly column. Could you have some time on the schedule for new provider on-boarding, or resident rounds, etc.? You can ask for the moon, and you might just get it. It doesn’t hurt to ask for milk with your cookies!

Lastly, when you’re teaching your 10-minute sessions, don’t forget to include contact information on any handouts or information provided. Advertise your services and ability to perform office visits, rounding education, etc. The most important thing is to demonstrate that you are a resource and are always willing to assist in the providers’ efforts to obtain quality documentation. You could be pleasantly surprised at how many physicians take you up on your offer and seek out additional information from you!

Editor’s Note: Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, CDI education director at HCPro in Middleton, Massachusetts, answered this question. Contact her at lprescott@hcpro.com. For information regarding CDI Boot Camps visit www.hcprobootcamps.com/courses/10040/overview. 

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