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Note from the Associate Editorial Director: What’s so special about ACDIS?

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Associate Editorial Director Melissa Varnavas

By Melissa Varnavas

In short, the membership. There are more than 5,500 ACDIS members now as we celebrate our 10th anniversary. That’s the size of a city. Sure, it’s not a large city but it’s definitely a community. It’s a community that’s chosen to live together and work together and ensure that its neighbors succeed. And that’s an amazing and special thing to be a part of in this day and age.

But it’s been that way since the start of the organization. Back then everyone was scrambling to figure out the best way to do this job. Back then everyone was looking for the best clinical indicators to help win their physicians over. Back then everyone was struggling to find their niche within the hospital hierarchy of department reporting structure. So everyone shared. Everyone shared just about everything they possibly could. [more]

CDI Week 2017: Celebrations nationwide

Last week, ACDIS celebrated our seventh annual CDI Week, recognizing professionals across the country for the incredible work that they do. Facilities and local chapters nationwide joined the fun, embracing the 2017 theme, “The Wild West: New Frontiers in CDI,” fully.

We were lucky enough to get our hands on a few photos from last week’s activities. Please enjoy this little slideshow we put together. Thanks for another great CDI Week!

Note from the Associate Editorial Director: A Little Local Chapter Love

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Associate Editorial Director Melissa Varnavas grabs a picture with a Local Chapter leader from Kentucky at the 2017 Conference!

By Melissa Varnavas

Next Friday, August 11, ACDIS Editor Linnea Archibald and I will head down to Newton, Massachusetts for the third-annual joint ACDIS/AHIMA New England CDI Symposium. The leaders of the MaHIMA, NYHIMA, and MA ACDIS have met for months to develop a comprehensive agenda to fit the educational needs of both coding and clinical documentation professionals.

The full-day event, sponsored by 3M, was originally the brainchild of then ACDIS Advisory Board member Walter Houlihan, director of HIM for Baystate Health in Springfield, Massachusetts. Houlihan, at the time, served as the president of the MaHIMA and, although his time in that role was ending, he had yet to see his vision for a multi-state event come to pass. After mentioning his hopes in a passing phone call, we decided to see if we could, in fact, bring this idea to fruition. The first year, more than 100 attendees arrived. The second held nearly 160. Baystate Health generously hosted those first two events.

This year, attendance has topped 200 and the registration has closed due to the constraints of the room size (although there is a wait list).

This is an amazing story about the importance of collaboration and the value of networking and education in our tiny slice of the healthcare industry we serve. And it’s a story that’s not just happening in New England but is playing out across the country. Every week in this email newsletter, we list local chapter upcoming events and offer a tip or tale about what’s happening at the local level. Recently, on ACDIS Radio, we remarked about the number of full-day events coming up.

In August, not only do we have the New England event but also North Carolina and Florida are holding full-day educational sessions. In September, both California and Alabama hold full-day events. The California event will be its third annual, and generally gathers more than 200 attendees. The leaders from each of the three Missouri ACDIS chapters have been meeting for more than a year to plan their big full day event coming up in October. Last year there were nearly 150 attendees and this year they expect to reach 200 attendees as well. South Carolina and Oregon also hold events in October and although it’s still in the planning stages, Texas hopes to have a full-day event in October too.

These volunteer leaders have done a tremendous job planning these events for the benefit of their communities. We cannot thank them enough for their efforts and hope that you, too, reach out to them, volunteer, attend, extend your own involvement in this, our ever growing, ACDIS community.

Editor’s Note: Varnavas is the Associate Editorial Director for ACDIS. To find out about what’s happening in your neighborhood visit the local chapter page. To learn more about starting a chapter or networking group, scroll down below the map to read our local chapter leadership resources. Contact her at mvarnavas@acdis.org.

 

Conference Conversations: What are ACDIS speakers looking forward to most?

ACDIS 2017

ACDIS 2017

“It’s in Vegas. Need I say more?” jokes William E. Haik, MD, FCCP, CDIP, who presents “Sepsis: 1, 2, 3—RAC Attack!” on Day 1, in Track 1, at 1:45 p.m.

Hardly a week goes by without a mention of sepsis in the medical literature, whether peer-reviewed scientific journals or non-peer-reviewed medical publications. Recently, more evidence has surfaced that seems to support the importance of Sequential Organ Failure Assessment (SOFA) in the risk assessment of sepsis patients, according to a recent White Paper on the topic from the ACDIS Advisory Board. And there continues to be conflict between clinical language, coding language, and the language required by quality assessment programs. (Read the related White Paper on the topic on the ACDIS website.)

But Haik, a founding member of the ACDIS Advisory Board, has a knack for breaking complicated clinical and coding conditions into manageable pieces of information, providing concrete examples of what clinical indicators CDI specialists should look for in the medical record and how to best craft a query to convey the patient’s condition in codeable terminology. Just as he has a knack for a quick comeback and rich and hearty laughter.

“We arm wrestle during my talk,” he says. “Just kidding,” he adds. “In reality, I’m trying to get participants to think inside the box! I want to get everyone to think clinically as a physician would.”

Striking a serious tone, he adds that presentations on quality, hierarchical condition categories, and value-based purchasing represent topics of interest. “I’m really looking forward to expanding my knowledge,” he says.

He’s not alone. The 10th annual conference features many physician presentations including that of Ronald Hirsch, MD, vice president of the regulations and education group at AccretivePAS Clinical Solutions, who presents on Day 2, Track 4, 11:15 a.m. to 12:15 p.m.

Hirsch knows how CMS’ regulations and guidance can confuse even the most astute clinician with its vague and often contradictory instructions. Nevertheless, these regulations affect everyone—doctor, patient, bedside nurse, case manager, CDI, billing and coding, even healthcare executives.

While his presentation “Medicare Regulation Update: Practical Application for CDI Professionals” promises to shed a light on this often opaque information, Hirsch is looking forward to learning just as much from his peers and other breakout sessions throughout the conference.

2016 pre-cons

2016 pre-cons

“With the breadth of courses available at the conference, I expect to walk out with a much deeper understanding of CDI. I can’t wait for the pre-conference physician advisor Boot Camp. It will be an honor to hear from Erica Remer and James Kennedy, two of the most renowned physicians in CDI,” Hirsch says.

Fellow physician, Nicole Fox, MD, MPH, FACS, CPE, medical director of pediatric trauma and CDI at Cooper University Health Care in Camden, New Jersey “cannot wait to hear about other program’s successes,” she says.

Fox, who presents “Playing to Win: How to Engage Physicians in Clinical Documentation Improvement,” on Day 3, Track 3, from 11 a.m. to noon, says she’s particularly interested in ambulatory CDI as Cooper University plans for its next area of growth and expansion.

Just as Fox looks forward to hearing other people’s CDI success stories, she’s excited to share her own, too. “One of the strengths of our program is physician engagement,” she says. “Physicians are never taught how to document, so they struggle with this much-needed skill set and are often hesitant to ask for help.”

Cooper University’s CDI program, however, tracks a 100% response rate to its CDI department queries, a rate at least partially attributed to the peer-to-peer education Fox helped establish.

“I think one of the general challenges with physician engagement is not recognizing that the best way for physicians. There is no substitute for a practicing physician embedded in your CDI program who will proactively educate peers and handle any concerns that arise,” she says.

Cooper University also has a remote component to its CDI program. Past ACDIS Achievement Award winner Kara Masucci, RN, MSN, CCDS, and her manager Rebecca R. Willcutt, RN, BSN, CCS, CCDS who both work at Cooper University, join Boston Medical Center’s Lara M. Faustino, RN, BSN, CCDS for a panel discussion on Day 2, Track 2, at 9:15-10:15 a.m., for a panel discussion on remote CDI efforts.

General session networking

General session networking

Like Fox, Faustino’s looking forward to learning from industry experts and peers and, of course, “networking! I always enjoy learning from a variety of CDI professionals from across the nation and it always amazes me how very similar we are, or how vastly different we approach the same types of challenges.”

When Jeff Morris, RN, BSN, CCDS, now CDI supervisor at University of South Alabama Health System in Mobile, first started in the role it was as a liaison between coding and physician staff to provide documentation education related to ICD-10 specificity. With numerous ICD-10 delays, however, Morris transformed the program, added staff, and expanded into focus areas such as CDI in obstetrics and gynecology, which he’ll explore on Day 1, Track 5, at 3:45 p.m.

“I am most looking forward to the networking and collaboration that occurs between CDI professionals during these few days. I always leave the conference refreshed and full of new ideas to bring back and implement at my facility,” Morris says.

There’s a lot to get excited about this year, especially with the 10th anniversary festivities. What sessions are you looking forward to most? What’s your favorite part of the ACDIS conference every year?

Lunchtime

Lunchtime catch-ups

Local Chapter Update: TN leadership recaps successful January event

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The joint meeting of ACDIS, THIMA, and THA

by Sherri Clark, BSN, RN-BC, CCDS, CCS, Clinical Documentation Nurse Specialist at the University of Tennessee Medical Center in Knoxville, and core member of the Tennessee chapter of ACDIS

The joint meeting of the Tennessee Chapter of ACDIS (Association of Clinical Documentation Improvement Specialist), THIMA (Tennessee Health Information Management Association), and THA (Tennessee Hospital Association) occurred on January 27. The meeting took place at the THA headquarters in Brentwood. The subject of the meeting was “The Impact of ICD-10 and Payment Reform on Clinical Documentation Improvement.” Four members of the core team of TN ACDIS chapter leaders (Sherri Clark, Kristie Perry, Cynthia Raymond, and James Kennedy, MD) and one chapter member (Kyra Brown) served on the planning committee for this joint meeting. Attendees were offered a number of hour-long presentations to choose from during the meeting, including:

  • Managing Conflicting Guidelines in ICD-10–CM/PCS
  • CDI, Coding, and Quality – The Three Legged Stool
  • Payment Reform in TN – Health Care Innovative Initiatives
  • Recovery Auditor Prevention Strategies: How to keep the predators away
  • MACRA, MIPS, APMS: Why CDI is a critical ingredient of the alphabet soup?
  • ICD-10-PCS and the Impact on CDI
  • The Case for Category II Codes
  • Hospital Improvement Network and other statewide databases: How are they used and the importance of quality data
  • The Impact of HCCs on Physician Accountability

The meeting drew physicians, coders, CDI specialists, and executives from THA. The presenters for the meeting included members of ACDIS, AHIMA, THIMA, and the THA. ACDIS Director Brian Murphy attended the meeting, as did all of the TN ACDIS Chapter leaders—Sherri Clark, Kristie Perry, Cynthia Raymond, Judy Rochelle, and James Kennedy. The joint meeting qualified for six continuing education units for ACDIS and AHIMA.

Editor’s note: Clark is a Clinical Documentation Nurse Specialist at the University of Tennessee Medical Center in Knoxville, Tennessee. She has been an ACDIS member since the spring of 2008 (she even attended the first ACDIS conference that year!) and a chapter leader since 2011 when the chapter was formed. For information regarding upcoming local chapter events, visit the website or email Clark at SClark@mc.utmck.edu.

Local Chapter Update: Washington leader reflects on chapter involvement

This photo was taken during a 2014 Washington ACDIS networking event. Leaders look forward to providing education throughout 2017!

This photo was taken during a 2014 Washington ACDIS networking event. Leaders look forward to providing education throughout 2017!

by Susan Browne, RN, MN CCDS

ACDIS has been central to my career as a CDI specialist. From attending the national convention every year, earning my CCDS credential, and hosting three ACDIS Washington State Evergreen Chapter meetings over the past six years (with much help!), I have met individuals from all over the country and nearby communities, including RNs, coders, and physicians with unique beginnings, but merging on the same path, all with the same goals and struggles. ACDIS has provided education, guidance, community, and a “big picture” vision for me.

Since its inception, our Washington State Evergreen Chapter persevered through bursts of enthusiasm and a paucity of hosting venues. We shared dessert potlucks and played CDI Jeopardy. We moved from local speakers to presentations from national consultants such as Berkeley Research Group and a lunch hosted by CDI Search Group. We have evolved as individuals, professionals, and as an organization.

This past year has been a hallmark for us as evidenced by the 40+ attendees at our summer meeting, where six individuals volunteered to step up and take accountability for the future of the Washington State Evergreen Chapter. They have already hosted a second meeting and scheduled a third (which will take place via webinar on January 20), with goals of being inclusive to the entire state and providing online education during the winter months. This new leadership team is enthusiastic and synergistic, eager to maintain momentum, and wanting to share the priceless resource of “networking” with other CDI professionals in our state.

I step away from the leadership group knowing it is in excellent hands and can’t wait to see what the future holds! Thank you for your dedication and hard work, Nora Tiffany, Barbara Anderson, Lillian Dickey, Satyananda Vuddagiri, Andrea Dyson, and Martha E. Khayyat, among other volunteers.

Editor’s note: Browne is the director of clinical documentation improvement at Capital Medical Center in Olympia, Washington. Contact her at Susan.Browne@capellahealth.com. Learn more about the Washington ACDIS Chapter and other networking opportunities under the “Networking & Events” tab of the ACDIS website www.acdis.org.

Local Chapter Update: New York regions begin CDI outreach

New York regions set networking plans.

New York regions set networking plans.

Three different regions in New York started CDI networking outreach in the last month—Westchester (County), Central (regional near Syracuse), and Champlain Valley (connecting CDI professionals on both side of the great lake in Vermont and New York).

In the Champlain Valley their hope is to “start with quarterly telephonic (GoToMeetings) sessions as a means of getting acquainted, exploring CDI educational needs/desires, and networking,” says Kellie B. Halsted, MSN/MHA, RN, CCM, CDI specialist at the University of Vermont Medical Center. (Contact her at kellie.halsted@uvmhealth.org.)

In Central New York, the group’s first successful meeting took place in Syracuse with great attendance both on site and via conference call, according to Dawn Burr, RN, BSN, CCDS, CDI specialist at Crouse Hospital (contact her at DawnBurr@crouse.org).  Burr says the open discussions were “both informative and timely considering the importance of CDI and coder collaboration,” and that they illustrated an opportunity for the group to continue to share tips and invite both team members to the subsequent meetings tentatively slated for April 2017.

In Westchester, more than two dozen CDI professionals joined at Northern Westchester Hospital in Mount Kisco, for a roundtable discussion of CDI productivity/metrics, types of reviews, types of units covered and staffing, use of query templates, and issues as pertaining to query response and varying escalation policies from site to site. The group plans to meet again in January/February. For more information, contact Kerry Seekircher at westchesteracdis@yahoo.com.

  • The next Maine ACDIS Chapter meeting is scheduled for Thursday, December 8, from noon-4 p.m., at St. Mary’s in Lewiston. For information, email Valerie Parent, at vparent@emhs.org.
  • The next St. Louis Missouri ACDIS Chapter meeting takes place Wednesday, January 18, 6:30- 8 p.m., at DePaul Health Center. Kay Piper, inpatient coding educator and member of the AHA Coding Clinic for ICD-10-CM/PCS advisory board will present. For information, contact dinello@ssmhealth.com.
  • The Massachusetts ACDIS Chapter meets Wednesday, January 25, 11 a.m. to 2 p.m., at Beth Israel Deaconess Medical Center in Boston. The agenda includes Litsa Georgakilas, RD, LDN, CNSC Clinical Dietician II, who will discuss malnutrition risk and assessment tools and Maureen Lira, RN, BSN, CWCN, CHI, who will discuss pressure ulcer staging and progression. Pizza/soda will be provided, however, RSVPs required to Faustino@bmc.org as space is limited.

Local Chapter Update: Photos from the Illinois ACDIS meeting

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Members of the Morris CDI department hosted the October event!

The Illinois ACDIS meeting took place Thursday, October 13, at Morris Hospital. They shared a few photos with us from their event—check them out and join us in congratulating them on a successful meeting! If you have photos from a recent chapter meeting or event, please e-mail them to us! For more information about upcoming events visit the Local Chapter pages on the ACDIS website!

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Thanks for a great meeting from the Illinois Chapter leaders!

Local Chapter Update: Wisconsin ACDIS meeting covers cardiology in-depth

Wheaton Franciscan in Wauwatosa

Wheaton Franciscan in Wauwatosa hosted the October WI ACDIS Chapter meeting.

The Wisconsin ACDIS Chapter met Saturday, October 15, at Wheaton Franciscan in Wauwatosa and featured a full day of speakers and networking.

The presentations were all given by members of the chapter and were well-received by attendees, who came from across Wisconsin and neighboring states.

While each presentation was equally informative, one in particular stood out to attendee Susan M. Burke, RN, CCDS, CDI specialist at Edward Hines Jr. Veterans Administration Hospital in Illinois. The session focused on cardiology, specifically arrhythmias, Takotsubo cardiomyopathy (broken-heart syndrome), and stenting. The two speakers, one of which was a cardiac nurse, used diagrams and interactive visuals to demonstrate blockages, including left bundle branch block (LBBB), specifically where they originate.

“It is one thing to know it from reading,” she says, “and another to see it in a schematic that makes perfect sense and creates links in the minds of the audience members—and this did.”

The presentation also included pictures of Takotsubo, demonstrating how it got its name and how it appears radiographically in the catheter lab. The research that has been done linking Takotsubo to other disease entities was completely unknown to Burke, who has been a nurse for more than 30 years.

“Though it may sound simplistic, I can tell you that having a good grasp of cardiology is not as easy as other body systems,” she says. “Hearing and now having a visual in my head helps me in my practice. I think the same could be said for most nurses and coders.”

Editor’s Note: For information about upcoming chapter events, visit the Local Chapter page on the ACDIS website and click on your state. Additionally, the CDI Strategies weekly publication includes an ongoing listing of upcoming events.

Local Chapter Update: Show-me state chapter holds first regional event

Pic caption: Starting from the left: Leanne Ridolfi (Alton), Bonita Baer (University of Missouri Hospital), Mariann Dinello (SSM), Karen Elmore (Boone/BJC), Rebekah May (University of Kansans Hospital), Michael McKelvey (Progress West), Christine Shattenfield (St. Luke's KC), and Tammy Brandes (Boone).

 Starting from the left: Leanne Ridolfi (Alton), Bonita Baer (University of Missouri Hospital), Mariann Dinello (SSM), Karen Elmore (Boone/BJC), Rebekah May (University of Kansans Hospital), Michael McKelvey (Progress West), Christine Shattenfield (St. Luke’s KC), and Tammy Brandes (Boone).

Collaboration makes us better, which our Missouri chapter proved last week after successfully hosting its first ever regional event at the beautiful Boone Hospital in Columbia.

The day went off without a hitch, says chapter leader Karen Elmore, RN, BSN, CCDS, as the group of nearly 100 attendees—including nurses, physicians, coders, and HIM professionals—tackled an ambitious agenda of six sessions, multiple networking breaks, and giveaways. Speakers included ACDIS Advisory Board member Sam Antonios, who discussed the physician advisor’s role in CDI, Jennifer Grub who discussed CDI in recovery auditor denial prevention, and Rebekah May who discussed severity of illness/risk of mortality, among other great presenters.

Other highlights of the day included a welcome breakfast, networking lunch, prize drawings, and special exhibitions from vendors, MedPartners, The Claro Group, and Chartwise. Attendees also enjoyed a view of the hospital’s healing gardens, which attendees boasted about throughout the event, says Elmore.

The planning committee consisted of those from Boone, Progress West, Alton, BJH, BJC, SSM, MU Healthcare, The University of Kansas Hospital, St. Luke’s KC and Cox Heathcare. Congratulations to the group on a successful event!