All Entries in the "ACDIS" Category
ACDIS launches 2009 CDI specialist salary survey
Nearly 300 people have already responded to the 2009 ACDIS annual CDI salary survey. In the survey, we ask for your open and honest input to help us develop the most accurate picture of the CDI profession today. Your answers help illustrate the average salary clinical documentation improvement specialists receive. Your answers help illuminate the design of a “typical” CDI program. Your answers help depict the average experience of CDI specialists.
Please only take this anonymous survey if you are a CDI specialist. If you are not a CDI specialist, please ask the CDI specialist(s) in your hospital to fill out this survey. Visit www.zoomerang.com to take the survey. A complete analysis of the survey will be provided to ACDIS members on the association Web site www.cdiassociation.com.
Here’s a sample of the results so far.
Individual effort equals organizational success
The role of the clinical documentation specialist has been in a state of flux for the past few years. We
Make a difference by getting involved.
wear many hats including that of nurse, coder, teacher, auditor, statistician, politician, and sometimes therapist. How many times have you had to evaluate the mood of a doctor prior to discussing a documentation issue, or been caught up listening to their problems in the office or with a colleague. The job description is constantly shifting.
Our profession has faced changing DRG’s, dealt with the complex nuances of the query process, and the avoidance of “leading queries.” There are additions to the list of Hospital Acquired Conditions, to contend with, concerns about Recovery Audit Contractor reviews, and the advent of ICD-10 to worry about. And that’s not to mention the transition and implementation of Electronic Medical Records.
During these stressful times, it has become apparent that CDI specialists are resilient, intelligent, resourceful, and indispensable! With these changes however comes stress. An article from MED Indiana, on Life Stressors That May Lead to a Cardiac Event listed several stress factors that may be faced in the clinical documentation workplace. They include:
- Changes in work hours or conditions
- Trouble with your boss
- Change in work responsibilities
- Change in work
- Major business readjustments
These situations may sound familiar to you and since most CDI specialists tend to be “long in the tooth,” or seasoned, as they say, we may be more affected by changes than most. This is one of the reasons that the Association for Clinical Documentation Improvement Specialists (ACDIS) organization is so important, for it gives us a forum to communicate, commiserate and share business practices throughout the state. It is a source for education and team building. A presentation at the 2009 National convention titled Restarting or Revamping Your CDI Program: A Case Study by Catherine O’Leary and Colleen Gary discussed various issues relevant to a CDI programs such as:
- How to hire the right team?
- How to retain your team and provide motivation? And…
- How to measure success?
One major issue addressed in the article seemed to be staff turnover. Not everyone can do this job and not everyone enjoys CDI work. It can be a thankless job. Occasionally we are perceived to be in the adversarial position of “Chart Police.”
The Clinical Documentation Specialist role should be well defined and program goals should be set and if needed, reset, again and again. Ongoing education and growth is fundamentally necessary in all professions and CDI is no exception. Involvement in ACDIS and other educational forums helps us get up to date information regarding our profession. And it helps prevent stagnation and boredom.
The experience of our membership is varied: Some have been working in CDI positions for many years in well established CDI departments and others are new and developing their programs from the very start. We need to reach out and help newcomers and they in turn can then help others that join our group in the future. There is strength in knowledge and there is strength in numbers. The ACDIS organization has the potential to someday have a major role in setting CDI policies and protocols.
In the words of Vince Lombardi: “The achievements of an organization are the results of the combined effort of each individual.” ~
Agenda for week ending Nov. 20
Hi y ‘all (although I’m a New Englander I thought I’d practice my southern drawl. They tell me the plural of y’all is all y’all. )
Here’s a look at a few events coming up this week:
November 18:
Clinical documentation improvement specialists in Connecticut meet at the Hospital of Central Connecticut, Bradley Memorial Campus, at 9 a.m. Meeting frequency and format, as well as a casual sharing of common CDI problems and strategies for success, top the agenda. For information, contact MaryAnn Shanley.
November 19:
ACDIS quarterly conference call 2-3 p.m. EST. This is a members-only call and dial-in instructions were e-mailed out to our membership list. If you did not receive an e-mail notification, and you are an ACDIS member, please e-mail ACDIS member relations specialist Sue Calabro at customerservice@cdiassociation.com. Sue will provide you with the dial-in number and passcode.
November 20:
The Maryland CDS Workgroup meets. Contact Christine Mobley, RN, Director of Clinical Documentation, Prince George’s Hospital Center at 301/618 6507 or by e-mail at Christine.Mobley@dimensionshealth.org.
Surgical Complications: Clinical Documentation Improvement for Compliant Coding and Accurate Quality Measures, 1 p.m. For information, call toll free 800/650-6787 or e-mail customerservice@hcpro.com.
Leading the question
Clinical documentation improvement specialists continue to have trouble discerning between leading and non-leading physician queries. The question often comes down to an understanding of the various previous “lives” of professionals. Nurses are used parrying over clinical decision making, so why should their queries regarding documentation be any different from the clinical questions they’re used to asking? Quite simply: because there’s money involved.
Sure it’s true just as Robert S. Gold, MD, founder of DCBA, Inc., in Atlanta, said in his
Questions remain over leading queries
article “Is asking for clarification ‘leading’?” that the government never clearly defined the term “leading” and many experts continue to banter over the logistics of the language. However, CDI specialists need to shine a bright light on the differences between the leading and non-leading query to protect themselves and their facilities from the coming onslaught of government auditing agencies.
While the likelihood of true healthcare reform legislation seems to be dwindling, President Barack Obama nevertheless continues to push against apparent payment abuses throughout the system. CDI professionals are meant to be a facility’s first line of defense against such abuses. It a CDI specialist’s job to make sure what was documented in the patient’s medical record is the most accurate description of the care the patient received.
Yet we still hear of facilities focused on Medicare only patients. We still hear about CDI programs directed to only look at records of a certain dollar value. We still hear tales of CDI professionals requesting specific language from physician simply due to some administratively imposed financial quota.
Inappropriate, leading queries, not only open your facility to an inordinate amount of risk but also jeopardize patient care. Generate policies and procedures for your facility that outlines the purpose and intent of your CDI program. Include your administrators, HIM leaders, physician liaisons, and compliance officers in the process. Create standard query forms that allow for the physician to further explain his or her documentation and even to disagree with the reason for the query.
For more information about physician query best practices and the legal architecture on which current query practice is based, read the Physicians Queries Handbook.
2010 ACDIS Conference agenda set
It’s been a real pleasure to be a part of the 2010 ACDIS Conference Committee, the 12-member volunteer group planning the annual conference behind the scenes, especially since we’ve completed most of the hard work and can move on to some of the more fun planning items.
The 2009 ACDIS Conference Committee did a great job. I'm looking forward to Chicago so I can capture a photo of my new 2010 committee friends.
ACDIS sent out the call for presentations shortly after the 2009 conference concluded. A record number of respondents offered a true plethora of programs to choose from so the group had some due diligence and research to do. From the list of nearly 40 speakers, each committee member picked his or her top 15 choices. ACDIS Director Brian Murphy compiled their responses and when the group reconvened everyone discussed the results.
The 2010 conference June 3-4 at the Hyatt Regency in Chicago will follow a similar format to previous years. It features two general sessions, a closing session question and answer panel, and 18 breakout programs for a total of 21 sessions. Highlights include programs on physician advisor strategies, risk adjustment for Medicare’s mortality and readmission indicators/AHRQ patient safety and inpatient quality indicators, performing CDI in outpatient ED setting, data mining, and tips to enhance the CDI program, among other topics.
The committee’s work continues, however. In the next few months we will explore opportunities for a poster session and develop ideas for some extracurricular fun. Sure a day of intensive learning is it’s own reward, and we will be in the beautiful Windy City, but you know what they say about all work and no play… so, stay tuned for more details on the way.
Three New York groups gather in December
My alma mater. I used to study on this lawn in the spring.
I went to school in Westchester County, New York, a 20-minute train ride from New York City, at the College of New Rochelle, in New Rochelle, NY. (The city most famously known as home to the Dick Van Dyke Show.)
So I was particularly pleased when Ann-Marie Carducci, RN, MPA, CPHQ, CPUR, CPC, CCS, director of utilization management at Montefiore Medical Center in the Bronx offered to get a local group going in the area.
But it’s been a bit of a bumpy ride and sadly with workload increases and additional responsibilities, Ann-Marie needed to pass the baton over to Deanna Holowczak, BSN, RN, Clinical Documentation Specialist, at Riverside Healthcare System in Yonkers. Deanna’s currently studying to earn her master degree in nursing administration while she juggles a number of other responsbilities. So thank heavens for the addition of Luanne Jennex, RN, clinical documentation specialist over at Westchester Medical Center, in Valhalla, who met with Deanna and agreed to help launch the first meeting of the Westchester County NY ACDIS group.
Luanne is also in school, finishing up her final courses on her way to earning her BSN, with a master degree potential. “Imagine that after 34 years of nursing?” she jokes. It just goes to show, she says, “you can teach an old dog new tricks.”
So, after some months of diligent grassroots networking efforts the Westchester group is ready to go, looking forward to hosting its first meeting in December. Anyone intersted should contact either Deanna or Luanna at their e-mail addresses above.
In a blog post yesterday, I talked a little bit about the geographical difficulties in getting a local networking group going. Like California, New York defies easy categorization. According to the state Web site, New York contains nearly 50 counties and more than 1,000 cities, towns, and “villages.” From New York City to Albany is 159 miles. The drive takes, according to Google maps, a mere 2.5 hours; roughly the same amount of time it takes to drive from the end of Long Island into the Big Apple. From Buffalo to Yonkers its a 408 mile commute.
When I went to school in New Rochelle I could make it out to Long Island for visit in about an hour, but I was a crazy college kid back then. Most seasoned residents know enough not to undertake such a drive.
So I appreciate the importance of Adelaide M. La Rosa’s efforts in Roslyn, NY. A registered
Long Island ACDIS promises to go the distance for networking needs.
nurse and director of the Clinical Documentation Improvement Program over at St Francis Hospital, she’s been gathering the names and contact information of interested CDI specialists for a few months now and is also ready to host the Long Island NY ACDIS Chapter’s first group meeting.
What I particularly appreciate about both these groups is their flexibility. Not only are they willing to volunteer to help their CDI peers but they’ve also expressed a willingness to include any CDI professional into the meeting that wants to come. So while there is currently no ACDIS groups in Queens or Manhattan for example, those who would like to make the trek off the big island and over to the long one are more than welcome, Adelaide says. The same holds true for our Westchester County hosts.
A great view of the Albany skyline. Join CDI specialists there for the December meeting.
There’s a similar story to tell about our third New York group being fashioned by Lois Rubin RN, BSN, CPUR, CCDS, Lead Clinical Documentation Specialist at St. Peters Hospital, up in Albany. Lois received a great response to initial inquiries about an ACDIS meeting in northern New York. Such a good response, in fact, she worried about the logistics of gathering such a diverse group of people. Nevertheless, she’s courageously forging ahead and plans to host the first meeting during the third week of December.
Such wonderful efforts on behalf of the profession are just another reason we are so energized by local chapter growth in general and in New York in particular.
If you are interested in getting a networking group going in your community please contact me at mvarnavas@cdiassociation.com.
Next ACDIS quarterly conference call Nov. 19
Hi ACDIS members,
Our next quarterly conference call is scheduled for Thursday, November 19, from 2-3 p.m. ET. This is a members-only call and dial-in instructions were e-mailed out to our membership list yesterday and today.
Please note: If you did not recieve an e-mail notification, and you are an ACDIS member, please e-mail ACDIS member relations specialist Sue Calabro at customerservice@cdiassociation.com. Sue will provide you with the dial-in number and passcode.
These calls are offered as a means for ACDIS members to network with one another, and to discuss any clinical documentation improvement related issues. We will have a few ACDIS Advisory Board members on the call as well. We encourage your comments, thoughts, and questions during the call. Additionally, if you have any suggestions for discussion that you would like to forward along to our advisory board, please e-mail me at the address below.
If you cannot attend the call, we will provide a digital recording for download on our Web site.
Thanks, and I hope you can dial in on the 19th.
Brian Murphy
California ACDIS meetings underway
California encompases more than 150,000 square miles.
California (163,696 square miles) contains nearly 60 counties and no less than 12 “regions,” according to the state park Web site, whose motto is “Discover the many states of California.”
It’s wise advice. For the past few months a number of ACDIS members worked diligently behind the scenes to organize local CDI gatherings in what Gov. Arnold Schwarzenegger calls “The Great State of California.” Initially, some said the state was just “too big” geographically for networking to work. After all, San Bernadeno County alone contains three million acres. The city of Los Angeles has the fourth largest economy in the United States.
This is a big state.
Fortunately, CDI professionals are not easily deterred. On Wednesday, October 23 the Central California ACDIS Chapter held its first meeting. Next week, on Tuesday, November 10, at 1 p.m., the Northern California ACDIS Chapter will meet. Plans for a Southern California ACDIS Chapter meeting are underway.
Sure, it’s true some states are more geographically challenging than others. But we’re seeing groups in Washington (71,342 square miles), New York (54,556 square miles), and yes, Texas (268,820 square miles) too. In New York City it can take more than an hour to drive from one borough to the next. But a drive from the tip of Long Island to the center of Manhattan takes just under two and a half hours (I’ll post more about developments in the Big Apple tomorrow). In California, too, they throw away the mileage measure in favor of the traffic report and the hour count.
Just as each geographic area presents unique meeting challenges, each area also presents unique clinical documentation improvement challenges. Payment methodologies and intensity of government scrutiny is not the same in Oregon as it is in Kansas. Such difficulties are one of the primary reasons we believe local networking is so important.
Even if a first meeting starts with five CDI specialists sitting in a restaurant talking about the difficulties of their day it helps! The primary intention of ACDIS chapters is to foster networking opportunities for CDI professionals, to establish a community of peers a CDI specialist can turn to, to talk about fears and concerns.
Ultimately, California CDI specialists decided to start with a single overarching California ACDIS group that will provide regular “virtual” meetings and three so-called “local” groups for the aforementioned areas. We expect and quite honestly hope that other, even more local, groups will soon grow to meet the diverse needs of CDI in the state.
We are so proud to be able to announce the formation of the California ACDIS Chapter.
For information contact:
Adriana van der Graaf, MBA, RHIA, CCS, CHP, National Director, Healthcare Reform Services at Integrated Revenue Management, who hosted the first Central CA ACDIS Chapter and will help organize the state-wide meetings. Contact her by phone at 760/448-1063 or by e-mail at avandergraaf@irminconline.com.
SheRee P. Garcia , RHIA, CHP, director, Health Information Management Services at UCSF Medical Center, who volunteered to host the first Northern CA ACDIS meeting. Contact her by phone at 415/353-2885 or by e-mail at sheree.garcia@ucsfmedctr.org.
Gloria S. Noell, RN, CCM, HCQM, CPUM, director of care management at Providence Little Company of Mary joins Wendy De Vreugd, RN, BSN, PHN, FNP, CCDS, senior director case management at Kindred Healthcare Hospital Division, West Region to gather CDI for a Southern CA ACDIS session. Contact Noell by phone at 310/500-6272 or by e-mail at Gloria.Noell@providence.org. Contact De Vreugd by phone at 714/899-5020 or by e-mail at wendy.devreugd@kindredhealthcare.com.
New e-learning courses open to ACDIS members
In my spare time, I am a creative writing student at a low residency program. Essentially, that
Not an actual sample.
means I’m taking a correspondence course on how to be a better writer. Every month I mail off a packet of papers. My adviser takes out her colored pens, marks them up, and sends them back. It is a little intimidating. I trust you share my “red pen” fears. But I graduate in January (hooray), and hopefully these writing lessons have made the Blog, e-newsletter, and other publications more enjoyable for you.
Sometimes, however, I catch myself wishing for a simpler way, something more akin to our own ACDIS online learning library. As far as I know though there are no writing CEUs for assistant association directors. But if you happen to be in the market for a convenient way to collect CEUs for coding, case management, or CCDS certifications, ACDIS can help.
Just last week we posted two new e-learning courses: one on hospital acquired conditions and another on present on admission. These new programs join sessions on 2009 IPPS MS-DRG update, understanding and applying the 2009 ICD-9-CM codes, inpatient coding: physician queries, and major complications/comorbidities.
Since I won’t be earning CEUs for writing this blog post, I’ll be jumping online in the coming weeks to tackle the ACDIS e-learning offerings myself. I promise to post my progress to all of you here. Feel free to place your bets now on how I’ll do.
If you’ve taken any of our courses please let us know what you think. ACDIS plans to add roughly four new courses every year and we’d love your feedback about what to concentrate on in 2010.
CDI takes center stage at forum in Chicago
Two ACDIS board members discuss CDI in Chicago this week.
Today and tomorrow the World Research Group holds its fourth annual Clinical Documentation Improvement & Coding Expo at the Hilton Suites in Chicago. We are extremely happy that ACDIS members will be well represented. The roster of presenters includes ACDIS Board Members Colleen Stukenberg, MSN, RN, CMSRN, CCDS, Clinical Documentation Management Professional at FHN Memorial Hospital in Freeport, IL, and Garri L. Garrison, RN, CPC, CMC, CPUR, director of Acute Care Services at 3M health information systems in Atlanta, GA.
Stukenberg will present “A CDI Orientation Process: A Checklist to Get Started.” Even when a healthcare organization hires consultants to start the CDI program staffing turnover and program growth requires ongoing training, she says. Her presentation later today explores the scope of a CDI orientation process. Tomorrow, Stukenberg moderates a panel discussion “How to Bridge the Gap Between Physicians, CDI Specialists, and Coders.” The discussion will have equal representation from each profession, naturally. Topics on the agenda include problematic terminology, evidence-based principles, common pitfalls in physician documentation, and clinical indicators in the medical record, among other items.
Before I stop touting Stukenberg’s expertise I want to just take a moment to laud her new book “Successful Collaboration in Healthcare: A Guide for Physicians, Nurses & Clinical Documentation Specialists,” which ties in quite nicely to her prestation tomorrow. The book describes ways in which nurses and physicians can collaborate to enhance patient safety and quality, and how this collaboration can have a positive effect on the financial aspects of an organization, Stukenberg says.
Garrison moderates a panel of professionals tomorrow afternoon to discuss “The Metrics for Evaluating a CDI Program.” Many ACDIS members say that once their CDI programs have been in place for a while, they need to ramp up their benchmarking and data collection. Garrison’s presentation explores how three different facilities tracked their CDI outcomes based on financial, quality, and other ratios.
We are so proud to have such talented board members and know that many ACDIS members also do their part to demonstrate the importance of clinical documentation improvement in their own communities. If you are an ACDIS member and have an upcoming speaking engagement we’d like to hear about it. Let us know by posting a comment here on the ACDIS Blog, on our LinkedIn or Facebook pages, or by shooting us an e-mail.