All Entries Tagged With: "ACDIS"

CDI specialist orientation (more CDI Talk inspiration)

One of the repeated conversation themes on CDI Talk is how to orient a new staff member (within an existing program), or how a small program can start its own CDI efforts and train its own staff. Parallel to those conversation threads are participants’ real hunger for more avenues and sources of education.

Let’s look at some of ACDIS’ online poll data to set the stage:

• July 2011: How many total years of professional experience do you have in healthcare (CDI, plus other)?
• 20 years or more, 60%
• November 2009: How long did it take you to get up to speed as a new CDI specialist?
• 3 to 6 months, 32%
• 6 to 12 months, 34%
• June 2011: How long do you think it takes to achieve an “expert” level of proficiency as a CDI specialist?
• 2 years, 35%
• 3 years, 22%.

And here’s one  final on-line poll data point to help me answer the question as to whether CDI managers are actually providing enough training to new staff members:

• January 2011: How long is your training period for new CDI specialists?
• 12%, 2 weeks
• 22%, 30 days
• 30%, 31 to 60 days
• 20%, 61 to 120 days
• 12%, approximately 6 months
• 3%, less than 6 months

It seems to me that those who indicated that it takes six months or more to get up to speed need more training than what I commonly consider necessary as part of orientation.  This data suggests that what is these new CDI specialists need is more of a mini-college training program.

Obviously there is a rather significant challenge—how to provide the level of knowledge and training along with the

(Image via Homeclick) It is a sink that is made so fish swim in it. Get it? Sink or swim.

appropriate mentoring to actively promote and support the new CDI specialists so they can succeed. Of course, there is always the consultant option which proves to be relatively expensive. Plus, a ‘mature’ program should not need to rely on such an expensive option for new staff orientations. At the opposite end of the spectrum is the ‘sink or swim’ method.

Thankfully, home grown and self-supported possibilities exist to constitute a middle ground between these two options. At the very least, facilities should implement an orientation or mentoring process where the experienced individual’s guidance can make a huge impact.

I believe the biggest challenge facing those hoping to implement a CDI orientation program comes from a lack of targeted, written learning resources. I consider one of the largest draws for ACDIS membership stems from the need for learning, resources, and accessibility to a community of knowledgeable and supportive peers. ACDIS provides such a community, with a quickly growing resource base. (If you’re a member, you ought to know. If not, go look at every part of the ACDIS home page).

In addition, ACDIS offers a few helpful handbooks and guides that can be re-purposed for orientation, such as:

• The 2012 CDI Pocket Guide
• The CCDS Exam Study Guide
• The CDI Specialists Handbook, second edition
• The Physician Queries Handbook

Furthermore, the only independent (i.e., not part of a consulting package) seminar I’ve found is HCPro’s CDI Boot Camp. While the total cost (fee, travel, hotel) may be prohibitive for many there is also the online version as an option. Again, a mature CDI program ought to be able to handle at least some of the orientation process internally.

Even with the valuable resources of ACDIS, some holes in new staff orientation remain. AHIMA and AHA’s Coding Clinic for ICD-9-CM provide further guidance, but even those resources do not cover everything. Several major elements of an orientation program are not addressed by the resources mentioned.  Just to get started, how about:

• Creating a tool that outlines in detail basic competency and knowledge expectations for the novice CDI specialist. This tool should also list areas for mid-level and advanced achievements to give new CDI staff a set of expectations for continued professional growth. There are some examples in the Forms & Tools Library, in the policies and procedures section (search for “staff orientation checklist), but not at the detail I envision.
• Curating a collection of vital subject articles and references. (Review the CDI Journal archives, the ACDIS Blog, and the Helpful Resources links just to get started on this collection. Add in other professional organizations and their publications such as the National Institutes of Health, AHIMA, AMA, and others and this would be a one-stop database of useful CDI knowledge.)
• Creating an outline of topics that the new CDI specialist needs to master before achieving their initial competency. Further, this outline ought to provide enough detail and referenced sources to serve as a complete training program guide.
• Sources would likely include the books and articles mentioned immediately above, along with sections of widely accepted texts such as coding guidelines, Faye Brown, and medicine texts like the Merck Manual.

Before starting to collect all those articles and tools, though, I should probably determine the basic elements of an orientation program! Below I’ve listed a few resources online which discuss this, including:

• The five key elements of a good orientation program
• The Community Tool Box: Developing Staff Orientation Programs
• Making New Employee Orientation a Success

After reviewing these, I must confess that my definition of orientation varies from those discussed above.  Still, several points are important to keep in mind to successfully bring a new staff member up to speed in the CDI world:

• Provide structured, purposeful training
• Offer a straightforward sequence of topics or activities to enable learning
• Give new staff members a written agenda complete with goals and measurable objectives
• Provide ongoing, two-way feedback and evaluation
• Supply appropriate resources and support
• Actively integrate the new person into the team
• Celebrate and welcome the individual and his/her accomplishments as they gain proficiency in their new role
• Pair new staff with an experienced mentor and provide oversight of their engagement
• Offer engaging, interactive, as well as some self-directed education

However, as mature and professional learners, CDI specialists must be responsible and accountable for their education and success.

Honestly, for a new or developing program that has to add or replace staff, the right consultant is worth the money.

At some point CDI programs need to be able to hire new staff and train them in-house. Creating a comprehensive training program does require a lot of effort and maybe it is work that some of you have already done?  If so, why duplicate work? Let’s see if we can compile a  “best of” list of what program components others have found successful and create a tool that we can share. Post your information here to the blog, e-mail me, or contact Associate Director Melissa Varnavas mvarnavas@cdiassociation.com

ACDIS Advisory Board final nominees: Cast your vote

If you are an ACDIS member please vote for four new volunteers to represent you on the Advisory Board.

Voting is now open for four ACDIS advisory board positions, for terms of service starting in 2012 through the end of 2014. Log on to the ACDIS website to select the four candidates you believe are the best fit for the association, and then cast your vote.

The results of the election will be announced in early February.

ACDIS advisors are important, volunteer positions that help shape the direction of the association and provide leadership, expertise, and representation for the membership. The term of service is a maximum of three years.

The voting page includes the nominees’ background in CDI and information on why they are seeking election. The vote will close end of business day on Tuesday, January 31.

If you have any questions, please e-mail ACDIS Director Brian Murphy at bmurphy@cdiassociation.com.

Brian Murphy, CPC
Director
Association of Clinical Documentation Improvement Specialists (ACDIS)
200 Hoods Lane
Marblehead, MA 01945
781-639-1872, ext. 3216
bmurphy@cdiassociation.com

2012 ACDIS Conference includes new initiatives

Join us in beautiful San Diego for the 5th Annual ACDIS Conference.The 2012 5th Annual ACDIS Conference will be more exciting than ever, offering two days and three tracks of sessions on the latest trends and cutting-edge techniques to build, improve, and enhance CDI programs. We strongly recommend early registration to save more than $200. Also if you are planning to stay through the weekend, hotel rooms quickly sell out, so we encourage you finalize your plans as soon as possible.

You will gain a deeper understanding of the new coding and documentation requirements under ICD-10, strengthen your medical records for RAC review, and learn how to bring  new initiatives like observation and pediatrics to your program when you attend this year’s Annual ACDIS Conference in San Diego, May 11-12. Sessions on shock and kidney disease and cardiac diagnoses will deepen your understanding of pathophysiology and open up new query opportunities.

Return to your organization recharged and with a new level of proficiency for continued CDI success.

Visit the web site for new detailed session descriptions and faculty information.

What’s new at the 2012 conference

• Exciting new keynote speaker Dr. Janet Lapp speaks on “Change: The Choice is Ours”
• DOJ attorney discusses Medicare claims recoupment case
• More sessions than ever, including breakouts on neonatal and pregnancy reviews, at-home work arrangements, career ladders, and ICD-10
• Tracks on compliance, and on quality and its relationship to CDI

Join us for two exciting pre-conference events

The Physician Advisor’s Role in CDI: A Collaborative Approach for Success | May 8-9, 2012. Participants found this session was so valuable during the 2011 conference they asked us to expand it to two days. This seminar provides in-depth coverage of the essential functions of the physician advisor and his or her successful integration with the clinical documentation improvement (CDI) department. Participants will walk away with a thorough grounding in the goals and objectives of a CDI program, definitions of problematic terms in ICD-9 and ICD-10 and solutions for to resolve coding vs. clinical clashes, and strategies to promote physician engagement. Click here for more information or to register now.

ICD-10 for CDI Boot Camp | May 8-9, 2012. This intensive two-day course was developed especially for CDI specialists to provide an introduction to the fundamentals of ICD-10 coding. You’ll learn the differences between ICD-9 and ICD-10 codes, understand major changes to official coding guidelines, and develop the confidence to tackle the new system and query physicians for the greater specificity in documentation that the ICD-10 code set requires. Our expert faculty will review the codes and provide practical examples for hands-on learning. Click here for more information or to register now.

Don’t forget about the CCDS Exam

Certified Clinical Documentation Specialist (CCDS) Exam | May 12, 2012. The CCDS credential is the recognized professional certification for CDI specialists. A paper-and-pencil administration of the exam will be held Saturday, May 12, 2012 in San Diego. Exams are also held at computerized testing centers nationwide. Candidates who wish to take the exam must meet general requirements and one of four specified routes. You can learn more about prerequisites or apply online at www.cdiassociation.com/certification.

We’re looking forward to seeing you in San Diego!

Searching for the best of the ACDIS blog

What are your favorite posts?

In response to Don Butler’s call for the most popular ACDIS Blog posts, (What would your favorite blog post be?)I decided to take a look at our “analytics” to find out statistically which posts drew the most attention.

I looked at the growth of the ACDIS Blog since November 21, 2009 year-over-year through November 21, 2011. According to the dashboard, there were a little more than 45,000 visits to the site from 2010 to 2011 up from 33,500 visits from 2009 to 2010. There were 87,000 page views this past year up from 68,000, with roughly 20,500 absolute unique visitors up from 14,500 in the 2009 to 2010 time period.

In terms of content it seems like the post “Does your hospital use the Epic software system, let’s hear about it” has garnered the greatest number of visits with more than 3,700 page views, followed by “CMS releases crosswalk for ICD-9 to ICD-10 Translation” with 3,300 page views.

The rest of the top 10 included:

3. Malnutrition continues to be area of clinical concern

4. Query questions: When should you not query

5. Q&A: Querying for SIRS when clinical indicators are present

6. Final changes proposed to ICD-9 code set

7. Clinical Documentation Improvement: What is your definition?

8. Physician query handbook released

9. Feeing the brain on malnutrition documentation

10. Pressure ulcer coding and staging

While this list may have some data behind it, I’m not 100% sure I believe what the data illustrates. I have a difficult time believing that CDI specialists perusing the ACDIS Blog really loved reading the brief announcement regarding CMS’ release of General Equivalence Mappings (GEMs), a crosswalk of sorts between the ICD-9 and ICD-10 code sets. Similarly, while I understand that Epic is a large integrated healthcare information technology software provider, and that this particular post has probably generated the most “comments” for any post on the ACDIS Blog, maybe that only illustrates that Epic customers need more networking opportunities.

Other items which hit the top 10 are a bit more interesting as they seem to be common topics of discussion and areas which CDI specialists constantly seek updated information such as physician query best practices and commonly queried conditions like malnutrition, sepsis, and pressure ulcers.

To reiterate Don Butler’s initial question then, what would you, as the ever-growing number of ACDIS Blog readers, like to see more of in 2012? And… if you are interested in contributing, don’t be shy. Shoot me an e-mail mvarnavas@cdiassociation.com.

Happy Holidays from ACDIS

Dear ACDIS member,

From all of us on the ACDIS staff, we wish you happy holidays, a merry Christmas, and peace and prosperity in the New Year. It’s been a pleasure to serve you in 2011. We are looking forward to another great year of professional networking, collaboration, and providing you with the best resources and tools you need for success in this important and growing industry.

Finally, if you’d like to get a jump on holiday shopping for yourself or your staff, please browse our catalog of CDI products and take advantage of our special discounts.

All the best,

Brian Murphy and the staff of ACDIS
bmurphy@cdiassociation.com
www.acdis.org

Quarterly conference call for ACDIS members scheduled

Quarterly conference call slated for November 17.

The next ACDIS membership quarterly conference call is scheduled for Thursday, November 17, from 1-2 p.m. ET. ACDIS members will receive dial-in instructions via e-mail. Note that due to heavy call volume, we recommend that you dial in 10 minutes early.

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.

If you have a question to ask, or suggestions for discussion on the upcoming call, please e-mail ACDIS Director Brian Murphy at bmurphy@cdiassociation.com. These calls are a great way to ask a question, air concerns, or gather input on CDI policies or procedures in your facility. While we cannot guarantee your question or discussion point will be addressed on the call, we will try to address as many as possible.

As a reminder, recordings of all quarterly conference calls are posted as digital downloads on the ACDIS website.

What would your favorite blog post be?

Which blog posts have made you smile most over the years?

When writing last week’s post “Voices & Perspectives,” I starting thinking about all the different ACDIS Blog posts I’ve enjoyed reading over the years.

The ACDIS Blog has been active since March 2008, and there are a good number of visitors, many of whom I suspect read it regularly and certainly not all of whom are ACDIS members. This causes me to wonder, what are readers’ favorite posts?

I want to ask this question from several perspectives.

1. What are your favorite types of posts?
   1. Industry news:
      1. Information and analysis about at is happening with CMS, RAC, MIC, quality, industry trends, OIG, etc.
      2. News of changes to ICD-9 codes, Coding Clinic for ICD-9-CM, MS-DRGs, etc.
      3. Information regarding consulting and vendor services
      4. ICD-10 implementation news and tips
      5. Information regarding other industry associations such as AHIMA and ACMA
   2. ACDIS announcements regarding:
      1. The annual conference
      2. Local chapter meetings
      3. Certification
      4. ACDIS growth and development
      5. Publications and webinar announcements
      6. Advocacy efforts
      7. “Introductions” to ACDIS staff and board members
   3. Case studies from CDI professionals regarding:
      1. Projects
      2. Challenges
      3. Successes
   4. Clinical/disease topics
   5. Philosophy/ethics
   6. Physician relationships
   7. CDI process and policy development
   8. Book excerpts
   9. Posts from ACDIS’ sister publications such as JustCoding.com or Case Management Monthly
   10. Q&A from membership
   11. Resources and references
   12. Fun topics like cartoons or holiday theme
2. Which individual posts really stand out in your mind?
3. Which posts do you most frequently reference back to?
4. Who do you like to hear from the most? Is there anyone else you’d like to hear from?
   1. ACDIS staff
   2. Experts within the CDI and related professions
   3. “Regular individuals” CDI specialists, local chapter leaders, CDI managers
   4. A specific presenter from a local or national conference?
   5. An author of a book or webinar?
   6. Experts from related areas within HCPro?
   7. A guest from another professional organization?
   8. Directly from a consulting or service company?
   9. An academic individual?
   10. Physicians:
       1. CDI Advisors?
       2. Leadership?
       3. Clinical experts?

So, let’s hear your thoughts and requests! Don’t forget to ‘nominate’ specific individuals!!

Voices & Perspectives

Open dialogue is the most valuable tool we have to grow the CDI profession.

I see strong evidence that ACDIS is involved with the broad project of defining and expanding effectiveclinical documentation improvement (CDI) practice. For our association to thrive in this endeavor, however, a chorus of voices and perspectives from the CDI community are needed.

In the course of this discussion we must actively maintain a communal understanding of what CDI encompasses. We must continuously ask each other:

• What do CDI specialists do that sets them apart?
• What kinds of activities identify a CDI staff member?
• What knowledge, skills, and abilities do the majority of practicing CDI professionals demonstrate?
• What are the characteristics of strong CDI programs?

To keep our profession (and our professional organization) strong, we need to participate in respectful, professional debate. We need to foster discussions surrounding philosophy, growth, ethics, new projects, and/or fundamental focus areas not just for ACDIS as an organization but for all of us working in the industry. Through this dialogue we will be able to find additional ways to effectively promote the fundamental aspects of CDI, to continue to grow and adapt professionally.

I believe ACDIS offers great resources toward fostering this discussion including:

• The quarterly online publication CDI Journal
• Benchmarking surveys with expert analysis and commentary
• Annual conference
• State networking chapters
• The ACDIS Blog
• CDI Talk

This blog and CDI Talk are two outstanding venues that I feel are particular venues which promote fast, interactive conversations.

I absolutely love reading the ACDIS Blog. I find the posts informative, thought provoking, reflective, introspective, and challenging. I expect (and consistently observe) well written and cogently argued viewpoints. In my opinion, the ACDIS Blog provides:

• Important news items that highlight information, events, activities, or resources that all practicing CDI specialists ought to know and understand
• A venue for the expression of individual thoughts and concerns by those with enough courage to explore and share what they feel to be the heart and soul of a CDI professional’s life
• An arena where we, as CDI professionals, can truly look forward to what the future of CDI might be
• Thought provoking content which challenges us (and allows us to challenge others) to uphold the highest expectations for ethical behavior
• A wonderful group of posts that entertain and delight, which bring a smile and a laugh when we need it the most.

I’ve found inspiration along with practical tips from shared individual experiences on the ACDIS Blog. And I’ve found that the discussions about challenges we all face have provided me with support, encouragement, and new strategies for growth that I have been able to implement in my own program. What’s more, the content on the ACDIS Blog is free, open to any interested professional.

Though the blog is important, the CDI Talk listserv forum which is available to ACDIS members provides a faster method for CDI specialists to reach out, ask a question, and be assured of responses. CDI Talk offers smaller bits and pieces of the more formalized discussions found on the blog, as well as all of the opportunity for individual interactions and questions. It is really is a fun community to belong to.

To me, the growth of our CDI profession and of its professional association, ACDIS, often feels like a process of discovery. Our profession will only continue to improve as long as we listen, reflect, and discuss the viewpoints everyone offers. I encourage everyone to discover their own interesting, exciting or passionate topic and write an original blog post, or start a CDI Talk conversation.

I’d love to see broad participation from everyone in these conversations and explorations. Thank you to the wonderful folks who currently contribute! A vision for CDI that includes professional growth and development needs a great variety and wealth of participation, of voices and perspectives, so please, join the conversation.

ACDIS 2012 conference exhibitor prospectus offered

The prospectus for the 2012 ACDIS National Conference in San Diego is now available.

We’re in the final stages of choosing speakers and sessions for the 5^th Annual ACDIS National Conference, to be held May 10-11, 2012 in San Diego. But signups are underway for our exhibit hall.

ACDIS quarterly conference call this week

Quarterly conference call slated for August 18.

The next quarterly conference call for ACDIS members is scheduled for Thursday, August 18, from 1-2 p.m. ET. ACDIS members should have received their dial-in instructions via e-mail. To access the call, dial the toll-free number, and enter the password/guest code. If you did not receive these instructions e-mail ACDIS Director Brian Murphy at bmuphy@cdiassociation.com.

Please note that due to heavy call volume, we recommend that you dial in 10 minutes early.

These calls are offered as a means for ACDIS members to network with one another and to discuss any CDI 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.

We want your questions, ideas!
Please pass any suggestions for discussion on the upcoming call, or questions you may have for the advisory board, via e-mail to bmuphy@cdiassociation.com. Conference calls are a great way to ask a question, air any and all concerns, or gather input on a policy or procedure at your hospital. While we cannot guarantee your question or discussion point will be addressed on the call, we will try to work in as many as possible.

If you cannot attend the call, we will provide a digital recording for download on our Web site.