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Pre-Conference Q&A: ‘The Physician Advisor’s Role in CDI’

James S. Kennedy, MD, will present a two-day pre-conference regarding the role and responsibilities of physician advisors for CDI.

Editor’s Note: Over the coming days and weeks, we will post a series of Q&As with presenters and participants from the 2012 ACDIS Conference in San Diego. Today’s post features James S. Kennedy, MD, CCS, ACDIS Advisory Board member and a director at FTI Healthcare in Brentwood, Tenn. Kennedy will co-present the ACDIS pre-conference event titled “The Physician Advisor’s Role in CDI: A collaborative approach for success.” The two-day session takes place Tuesday and Wednesday, May 8-9, 8 a.m. to 4 p.m.

Q: What role should CDI physician advisors play in audit review and data analysis?

A: Clinical Documentation Improvement (CDI) physician advisors are critical to the entire process of ensuring the integrity of coded administrative data (ICD-9-CM and CPT) and its application to physician and hospital quality and cost efficiency measurement.

CDI is the process of preventing and reconciling inconsistent, incomplete, imprecise, conflicting, or illegible documentation to bridge the gap between treating physicians and coders. Physician advisors must be able to analyze data derived from these codes to target their efforts and should review the results from documentation audits as to hone their message.

Examples of these activities include:

1. Data Analysis: ICD-9-CM coded administrative data is primarily used to determine, measure, and report severity and risk adjusted outcomes and cost data for various metrics.  These include cost, length of stay, complications, mortality, readmissions, and the like.

   Risk and severity adjustment means that the actual metric being measured (observed) is compared to the likelihood of that metric occurring (expected).  CDI ensures the integrity of the expected metric, usually increasing it since many clinical descriptions are incomplete or imprecise, thus reducing the risk-adjusted metric.

   Take for example the Colorado Hospital Report Card. Note that Colorado reports an actual mortality rate and a “risk-adjusted” mortality rate.  There are instances when the risk-adjusted mortality is less than the actual mortality since the death rate is less than expected.  There are others, however, where the risk-adjusted mortality rate is higher than the actual.

   Another aspect is measuring complications of care.  Some facilities code incidental serosal tears as “accidental lacerations.”  Physician advisors would want to analyze Patient Safety Indicator data at their hospitals (e.g. from Thomson-Reuters, the Delta Group, and the like) to determine if the data driving these metrics is accurate.

   For example, look at the website “CareChex,” a division of the Delta Group, to see how it ranks overall surgical care in Chattanooga, Tenn.

   Physician advisors should partner with their chief quality officer to learn how these risk-adjustment methodologies work and how the definition, diagnosis, documentation, and coding of these conditions factor into them.

   Armed with this information, the physician advisor can help develop systems that work with providers to accurately capture these metrics.

2. Chart Audit: Physician advisors are integral to the chart review, given that they recognize the clinical scenarios that are often not documented completely and precisely.  Imagine a patient admitted with a pH of 7.02, pCO2 of 100 and a pO2 of 40 and stupor requiring mechanical ventilation but only described as respiratory insufficiency with CO2 narcosis. This patient has acute hypercapnic respiratory failure and could potentially be labeled as having a metabolic encephalopathy. The physician advisor recognizes these scenarios and can help concurrent reviewer and coders recognize the circumstances whereby query would be prudent.

AHIMA published a nice summary of the role of the physician advisor, and you read more about the role in the January edition of the CDI Journal.

Q: How can a physician advisor help achieve buy-in from the medical staff for CDI efforts?

A: The best ways I know to achieve buy-in from the medical staff are to:

1. Make CDI an academic exercise, emphasizing the definitions of clinical conditions.  These can include:
1. Transient ischemic attack versus stroke. Note that the 24-hour time frame is completely eliminated.
2. Acute myocardial infarction vs. accelerated angina. Note the critical role of properly calibrating troponins and equating elevated levels with “symptoms of ischemia.”
3. Acute kidney injury.  Note that it is only a rise of the serum creatinine of only 0.3 mg/dl

2. Ask the quality officers of your hospitals to generate individual physician reports regarding their own cost efficiency and outcomes, outlining the actual and the expected outcomes.  Should a physician see that their expected mortality rates is higher than expected and that CDI is a strong solution addressing the “expected” component, his or her participation and interest is likely to increase!

Q: How involved should the physician advisor be in the day-to-day operations of the CDI program?

A: Given that most physician advisors have their own private practices, they do not need to be involved with the direct day-to-day operations of initiating queries. They should, however, be available at designated times to support concurrent reviewers and coders regarding the clinical circumstances assessments of clinical situations requiring query and to aid in their construction.

If at times a physician does not respond, the physician advisor may potentially have a collegial conversation about a query.  One must be cautious, however, to frame this conversation about defining a patient’s condition without putting the physician on the defensive.

One of the fun things a physician advisor can do is support the development of the electronic medical record as to make the capture of complete and precise documentation less onerous to the practicing physician.

Q: What are you looking forward to most about this year’s ACDIS Conference?

A: Wow….what’s not to look forward to? ACDIS is everything a CDI professional, coder, or physician advisor would want—clinical conversations, problem solving, medical informatics, and collegial interaction with like-minded individuals working to solve the challenges we all share.

It’ll be great to be with old friends and make new ones!  Not to mention that all this occurs in downtown San Diego, in a phenomenal setting (this is a beautiful hotel), right next to Balboa Park (let’s rent a bicycle and ride!) and close to Sea World, the ocean, and all that makes southern California great!

I must say, however, that the most anticipated event for me is the Physician Advisor pre-conference where Dr. Trey LaCharité and I spend two days training physicians from all over the nation to understand and embrace CDI principles.

I feel that this contributes to the professional practice of medicine and empowers physicians to successfully negotiate healthcare reform.  Needless to say, I’m very excited about the conference!

Diagnose first, admit second

Consider CDI collaboration with case management to target documentation concerns in the emergency department.

Among other tidbits in my background, I’m a recovering case manager.  It’s a hard, often thankless job, and it never ends.  I don’t think I could do it again, and I give lots of credit to those who still work in this field.  Nevertheless, I have had many occasions to interact with case managers in my previous role as a CDI specialist, and now, a CDI consultant.

As a recovering case manager, I often shied away from dealing with the CM department, but I’ve come to realize that not developing collaborative processes can be a huge mistake. When we avoid case management, we avoid the opportunity to build an ally. We both want medical records that reflect the optimum patient acuity, and that will survive RAC and other audits. And this process starts at the hospital’s front door.

Case managers review patients in the emergency department for admission criteria. If they know that chest pain and syncope and abdominal pain are RAC targets, and that documentation of diagnoses instead of symptoms may move the DRG out of the RAC crosshairs, they can communicate this to the physicians. I like to think of it this way: when the physician writes nothing of consequence, the CDI specialist looks for clinical findings and asks for the diagnosis, while the case manager asks for clinical findings and the treatment plan that support the medical necessity for the admission and strengthen the diagnosis that we just got.

It’s a symbiotic relationship.

I’ve had occasion to work with the case management team at a client hospital, and we decided to put our collective heads together to see how we could educate ED physicians not to admit patients who didn’t meet criteria. We chose as our slogan:  “Diagnose first, admit second!”

We created one page flyers to be posted in the ED and distributed to the ED physicians on popular topics such as chest pain and syncope.  In the flyers, we briefly gave suggestions of alternative diagnoses, defined what is needed to meet admission criteria, and encouraged physicians to consult with case management before writing that admit order.

At the same time, I’ve been presenting a weekly series of lectures to the case management department, very similar to what I would use to teach a new CDI specialist, but adding a little twist that ties clinical documentation improvement to case management.  It’s been a big hit.  They are eager to help teach physicians not to write “CHF” or “urosepsis,” and they want to learn more.  I’m going to give them all they can handle, including helping them read their PEPPER and use it to their best advantage.

Never assume that because someone doesn’t understand what you do, that they don’t want to understand what you do.  It’s like working with physicians and nurses; when you show them how your job relates to them and how it benefits everyone, you get more cooperation.  And as we used to say, cooperate and graduate.

Q&A: How to resolve DRG confusion

Q: Confession. I am very frustrated. I am fairly new to CDI. I have a nursing background. I’m trying to understand how

Learning how to navigate the coding and DRG landscape can be daunting. Don't worry. Others have had to learn this too. Ask for help and know you are in good company.

the coding and DRG system works. But when I look up a diagnosis in the DRG Expert in the alphabetic index to diseases it is not listed as I would expect it to be.

Take for example, bradycardia. It is not listed under that term or arrhythmia.  Yet, it is listed under cardiac arrhythmia. For another example, how about anorexia? The only listing is anorexia nervosa—not unspecified.

I also find it ironic that I cannot infer what a physician is stating (it has to be documented precisely) but when I have to look up a term I have to guess its meaning.

Do you have any advice for me?

A: Your frustration is very common among new clinical documentation improvement (CDI) specialists.  The publishers of the DRG Expert did not include the same type of Index to Diseases that you would find in Volume I of an ICD-9 code book—probably to save space. The Index to Diseases alone in my code book is 380+ pages.

This is one reason that during the CDI BootCamp I mention so many diagnoses as we review Medicare Severity Diagnosis-related groups (MS-DRGs) in a major diagnostic category (MDC) and either have you highlight them or write them in, because I, too, had exactly the same issues you are having.

Every CDI team should also have a coding book in their department to use as a reference (ask your facility HIM department if they have an old one you can have), especially if you do not have access to the encoder (coding and reimbursement software), which would let you look up whatever you wanted—however, even that has limitations, because search terms often use “coding language” rather than the everyday language of clinicians.

As far as your comment regarding the irony of the situation, all I can say is “Right on, girl!”  It is the reason we have taken on this role. We were hired to become the “translators” or “interpreters” to ensure that the clinical language matches the language needed by the coders. Acquiring the skills to understand both of these languages, along with the ability to translate from one to the other, is what makes us, as CDI professionals, unique.

As a final note, I just want to share that my very first DRG Expert was COVERED from end to end with handwritten notes, stickies, and slips of paper. I used this book for three years, copying my info into each new edition until I was granted encoder access. Every time I asked a coder where to find something I wrote it in the book—especially those diagnoses that had really strange “code” descriptions.

I hope that I can assure you, that by this time next year, you will have many of these coding terms memorized.

I tell all my CDI BootCamp students that there is a long learning curve to this position, so don’t worry. While some people catch on quickly, for most it may take up to six months before that proverbial light bulb finally goes on and frequently it takes up to a year to feel confident in the role.

Don’t get discouraged. Most CDI specialists will tell you the same thing! Before you know it, you will find yourself sitting in traffic, converting license plate numbers into DRGs or diagnosis codes.

Q&A: Maryland CDI network answers member’s renal failure documentation inquiry

Q: If the physician documents throughout the record that the patient has acute renal failure (ARF)—he documents this in emergency department notes, history and physical, admitting diagnosis, and in the progress notes but fails to add it to the discharge summary—would the coder be allowed to pick up the acute renal failure and code for it or would the coder leave it out and until the CDI specialist queries the physician for documentation in the discharge note?

Additionally, if the physician documents ARF in the initial consult note while the patient was still in the emergency department and it is documented in the chart by the attending physician and the renal consult but the hospitalist who last saw the patient documents renal insufficiency in discharge summary, would you leave out the ARF completely just code the renal insufficiency or would you query the hospitalist?

A: “Oftentimes, diagnoses throughout the patient’s stay are left out of the discharge summary and yet are still coded, if there is documentation in the record to support those diagnoses.” states Lillian Keane, RN, BSN, CPC, documentation specialist at MedStar Health Good Samaritan Hospital.

Keane suggests also reviewing the labs (creatinine, glomerular filtration rate [GFR]) and using the RIFLE (risk, injury, failure, loss, end-stage kidney disease [ESKD]) classification published by the Acute Dialysis Quality Initiative (ADQI) group to assist in diagnosis of ARF.

In regard to the second scenario, Keane favors querying the physician for clarification since so many physicians use the term acute renal insufficiency and ARF as one and the same. “If the diagnosis of ARF is inconsistent with the RIFLE and there is conflicting documentation, I will query at that point,” says Keane.

“We also see the terms acute renal failure and acute renal injury used interchangeably at our facility,” says Cathy DeNoble, BS, RHIA, CCS, LPN, coordinator of Case Mix Information Management and CDI specialist at Johns Hopkins Health System in Baltimore. “They are easily misinterpreted acronyms with various definitions.  At our facility the attending is the final word and when in doubt…query never assume.”

Understanding the difference between the physician’s mindset and the coding rules, presents an educational opportunity, says Keane, who presented physician education sessions on RIFLE classification, differentiating acute renal insufficiency versus ARF versus azotemia and also the stages of chronic kidney disease.

Keane cites the September 2010 article of the month AKI: The Crossroads of ICD-9-CM and Medical Literature by James S. Kennedy, MD, as one resource, other resources on the ACDIS website include:

• Consider NKF definitions when documenting renal disease
• Column: AKI and the mess we’re in
• Acute kidney injury: The crossroads of ICD-9-CM and medical literature
• Q&A: Two query alternatives for acute on chronic renal insufficiency
• Use kidney key-words to sooth your documentation troubles
• Sample queries and educational posters in the Forms & Tools Library

Editor’s Note: Special thanks to The Maryland Hospital Association Clinical Documentation Improvement Workgroup for sharing this exchange. For information about joining Maryland’s networking events contact Christine Mobley, RN, director of clinical documentation at Prince George’s Hospital Center, at christine.Mobley@dimensionshealth.org.

Do you know who I am?

Sometimes causual conversations and simple kindness can open doors for CDI collaboration.

Scenario: You find yourself in the company of a physician you haven’t formally met, but for whom you have left queries (or may in the future). You’re in line behind the doc in the cafeteria or riding the elevator together, and you’re aware this is a great opportunity to say “Hello” and introduce yourself. What should you do?

I hope you put your hand out and start a conversation.

You don’t have to turn it into a big teaching moment. In fact, this might be the wrong moment to try that. Chances are the physician in front of you is lost in thought. Instead, make it a pleasant exchange.

“Hello, you’re Dr. Murphy, right? I’m Penny Richards, I work in the CDI department. I’ve sent you a few queries in the past. I just wanted to introduce myself and say ‘Hello’!”

Make eye contact. Smile. Don’t ask for anything business-related. Don’t ask the status of a pending query.

Keep this first face-to-face meeting upbeat and positive.  If the physician transitions to a business conversation, then by all means, follow—but let him or her take the lead.

Pass your few moments together with light conversation. End your time together with something simple, such as “I’m glad I had a chance to meet you. I look forward to talking with you again.”

Remember: You never get a second chance to make a good first impression.

Ask yourself how you’d like to be greeted? With “Do you know who I am?” or with “Hello, you may not know me, I’m Penny Richards and I’m happy to meet you!”

This easy-in-easy-out greeting style is a great way to establish yourself with the clinical team as someone who is non-confrontational and open to having a conversation rather than an argument.

It’s also a great way to set yourself up to roll out your “Five-Minute Speech” at your next encounter. More on that in a future post.

Collaboration: Coding and me

A Venn Diagram helps illustrate where overlapping interests lay.

I realize that many of the faithful members of ACDIS are, indeed, coders, but most of us have a nursing background, so I’m going to give my two-cents on the coding/CDI specialist relationships from a nursing perspective and hope that the coders among us will forgive me.

The first thing and the last thing that coders and nurses need to understand is that nobody knows everything.  If you remember a Venn diagram—yes, those big bubbles with the overlap in the middle that you learned in 7^th grade math—and apply it here, we have the coding world, and we have the nursing world, and we have that great big space in the middle where we cross paths. Nevertheless, we also must bear in mind that there is space on the left and right where never the twain shall meet.

Both nurses and coders have studied anatomy and physiology, we all know medical terminology, and we all have some understanding of coding guidelines and principles.  That’s where we meet.

But coders have studied coding, and they typically can code up to 30-40 charts or more per day with staggering precision. The average nurse doesn’t spend the time assigning CPT codes, or E-codes, or worrying about whether the femur fracture is of the head, the shaft, or the condyle part of the bone, the way coders do.

Likewise, the average coder has never been in the room with the hundreds or thousands of patients that the nurse has seen, has not personally observed or helped treat the signs and symptoms associated with the myriad medical conditions people can acquire, and does not have the in-depth knowledge of intricacies of medical management that nurses have.

When I first started as a CDI specialist, it took time for the coders to get used to me and what I could do for them—and to them.  Because my orientation was bare bones and my preceptor was literally in the next state, I had to learn by mistake. And boy, did I make mistakes.

I can’t tell you how long it took me to grasp that hypertension in a patient with chronic renal disease codes out differently than it does for hypertension in the general population. I’m still embarrassed to admit that I nagged a coder to take a vascular ulcer as a CC on a patient with peripheral vascular disease because I didn’t understand how to apply the combination code.

It took persistence and patience but eventually the coders realized that not only was I a fast learner, but that there were some things that I could teach them.  One coder was coding atrial fibrillation (AF) with rapid ventricular response (RVR) as ventricular tachycardia, which not only added CCs to the coding summaries, but drastically altered the dynamic of those charts.  As a former cardiac care unit (CCU) nurse, I knew that AF with RVR is absolutely not “v-tach.”  I argued my case, and even enlisted one of our electrophysiologists to help me explain the situation.

The electrophysiologist was able to verify that AF w/RVR is definitely not v-tach, and further emphasized that if v-tach were to be coded, it would completely change the treatment protocols he would have been expected to perform.  By pressing the issue, I might have lost our facility some CCs, but I think I saved us a lot of heartache in future audits.

I have tremendous respect for the work that coders do.  It pains me to see adversarial relationships between coders and nurses.  Everybody wants to be right, especially if their work is going to be graded negatively if they’re not officially right. But some nurses are just determined to prove that they know more than coders—and vice-versa.

I really miss the days when I could just call a coder for a consult on a complex case while the patient was still in-house, and when the coder could call me to ask my take on a confusing chart they were coding.

It may be difficult for more experienced coders to understand the need for a CDI program when they have been sending back-end queries for years without  help. So those CDI specialists who do have a nursing background may be in a situation where they need to prove their value—not by fighting with coders but by sharing our clinical expertise in a nonjudgmental manner.

We need to remember that everyone’s goal is an accurate, pristine chart, regardless of who gets credit.

I suppose there are some relationships that will always be sticky.  Let’s just make this one stick.

New materials posted to the ‘Forms & Tools Library’

There are a number of new materials available in the Forms & Tools Library for ACDIS members, including:

• A new “shelf” in the library specifically for ICD-10 training, preparation, and queries. ACDIS
  

  ACDIS members have lots of tools in their online toolbox.

  members can expect more tools, training materials, and sample queries to be posted in the near future. If your program has materials that you’d like to share please e-mail mvarnavas@cdiassociation.com with a brief description explaining the item and how it was created. Currently available on this shelf are:

  • An education poster regarding intracerebral hemorrhage
  • An ICD-10-PCS crossword puzzle
  • An ICD-10 preparation checklist
• Multiple new additions to our physician education materials shelf, including:
  • A revenue cycle flow chart
  • Tri-fold physician documentation tip sheet
  • Heart failure handout
  • Sample mortality letter
• New spreadsheets and checklists added to the policies and procedures materials include
  • An Excel spread sheet containing FY 2012 MS-DRGs with the national base rate
  • Length of stay, patient problem list worksheet
• New sample queries, including
  • Diabetes type and status
  • Signs and symptoms
  • Staging for chronic renal failure
  • Unspecified chest pain

As many of you know, the ACDIS Forms & Tools Library represents one of the best aspects of ACDIS membership. This, now expansive resource, comes from the generous donations of those working in the field who developed the materials for their own use in their facilities and decided to share it with other CDI professionals. If you have an educational presentation, poster, newsletter, sample query, job description, or other item you’d like to share, please e-mail ACDIS Associate Director Melissa Varnavas at mvarnavas@cdiassociation.com.

Physician Queries Boot Camp:Tales from the classroom

The new Physician Queries Boot Camp held its first session last month.

Last month I had the pleasure of teaching the first Physician Queries Boot Camp.  No kidding – it really was a pleasure! First of all, I didn’t have to get on a plane to get to the class site (yay!); and second, I got to see some previous students from the CDI Boot Camp – that was really fun!

I was looking forward to teaching this particular class because it’s so different from the CDI Boot Camp. What makes this class so different  is that it is only two days long and class size is limited to 16 students so  the classroom gets to be very hands-on and interactive.  There are individual activities and small group activities and opportunities for students to interact with, and learn from, each other.

The syllabus was based on feedback I received from the CDI Boot Camp students about topics they wanted to cover in more depth, such as:

• Practice writing queries
• Role-playing verbal queries
• Drafting queries and program policies and procedures
• Preparing for RAC audits
• Determining how to query for those high-volume, high-risk situations such as:
  • altered mental status
  • renal and respiratory failure
  • encephalopathy
  • and our good friend, malnutrition

We even have actual medical records to review – poor handwriting and all!  I heard lots of “how in the world do they expect a coder to read this?!” while attendees at that first session were doing their individual and group chart reviews.  Talk about real-life simulation!

Although the Physician Queries Boot Camp is designed for those newbie CDI specialists (generally those in the job for less than a year) I had one very experienced CDI specialist tell me that she learned a few new things, which I thought was terrific.  When I attend a seminar I feel that if I take away one new idea or concept that my time was well-spent.

Besides the actual didactic learning that takes place students go home with an draft outline for their own policies or procedures, some individualized query templates, as well as several sample policies and procedures they can modify for their own use.

For me, the highlight of the class was when I used a deck of playing cards to determine who would be a physician or a CDI specialist for the final activity that brings everything they’ve learned together.  Those who received red cards became CDI specialists and black card recipients were instantly promoted to physicians!  Each “CDI specialist” had to choose a physician and the duo practiced verbal queries.  The physician/student decided what “type” of physician he/she would be and the CDI specialist/student had to approach their physician, introduce themselves using their pre-developed 60-second elevator speech and then verbally query for one of the situations they identified during earlier classroom chart reviews.

I have to say – people can be VERY creative!  One of my “physicians” even used props: an iPhone, a pager,

Let's hope not all your physician/CDI staff interactions end up this way.

pencil, and chart.  This “physician” engaged in a spirited phone conversation when the CDI specialist approached, yelled out instructions to an invisible nurse, and more or less ignored the CDI specialist who stood waiting patiently for an opportunity to deliver her query.  Everyone got to have a turn being the physician and the CDI specialist, so those who enjoyed being the “uncooperative provider” had the tables turned when they had to be the one approaching the physician. They never knew just how the situation would unfold, sometimes to riotous effect!

It was beyond funny to see a CDI specialist deliver her well-thought out introduction and query, only to have the “physician” give her a hard time – again, and again, and again.  The “physicians” handed out the whole gamut of responses that you would typically hear: “So – do we get more money for this”? or “Yes, I get that, but how does this affect me personally?”

Lest you think that all of our “providers” were surly, some of the “physicians’ were congenial and receptive – which also turned out to be humorous since we could tell that the CDI specialist was “ready for bear.”  The varying “skits” demonstrated the value of being able to think on your feet when you verbally query a provider and showed examples of how you would respond in varying situations.

I can’t wait to do this again!

Book Excerpt: Coding and physician languages

This handbook regarding documentation tips comes in packs of 10 so it can be delivered to physicians, CDI staff, or coders.

Clinical documentation for coding purposes continues to be highly important as we work to obtain data for quality measures and payment. Such data rely on accurate coding, which relies on complete and accurate clinical documentation; they are dependent on each other. Indeed, the more specific the documentation, the more specific the ICD-9-CM (and in the future the ICD-10) code(s) will be, and in turn, the more accurate the severity, acuity, and risk of mortality (ROM) data will be.

Clinical coding allows for the reporting of mortality data to the World Health Organization (WHO), the reporting of morbidity data in the United States, and the provision of data to third-party payers so they can reimburse hospitals for care and services provided. Coded information is also the primary source for the administrative management of medical services and a source of epidemiological research and statistical data from inpatient stays.

Editor’s Note: This excerpt was taken from Coding and Physician Language: Strategies for Obtaining Complete Documentation, Second edition, written by Gloryanne Bryant, RHIA, CCS, CCDS.

Celebrate CDI Week!

Get creative! Send in your team videos of why CDI is so important.

The first Clinical Documentation Improvement Week takes place from September 18th – 24th. Its purpose is to recognize and celebrate the value of clinical documentation improvement programs and the unique skills and expertise of CDI specialists.

This week of recognition is brought to you by ACDIS, with support from our partners Chartwise and MetaHealth, (www.acdis.org), the premier professional organization for CDI specialists. As a part of our CDI Week activities, ACDIS has fielded a national CDI Week Industry Overview Survey, examining the state of the industry in areas including career advancement, data mining and reporting, electronic queries, and more.

We invite you to click here to visit the CDI Week section of our website, and download the PDF survey report free of charge.

You’ll also find a number of helpful resources at your disposal, including the following:

• Suggested CDI Week activities:
  http://www.hcpro.com/acdis/cdi_week_activities.cfm
• An electronic toolkit, including a poster, logo, powerpoints, and branded items for sale: http://www.hcpro.com/acdis/cdi_week_toolkit.cfm
• A media kit: http://www.hcpro.com/acdis/cdi_week_media_kit.cfm
• A special video message for your physicians about the importance of CDI: http://www.hcpro.com/acdis/cdi_week.cfm

The Association of Clinical Documentation Improvement Specialists (ACDIS) is a community of over 2,500 members in which CDI professionals share the latest tested tips, tools, and strategies to implement successful CDI programs and achieve professional growth. Its mission is to serve as the premier healthcare community for clinical documentation specialists, providing a medium for education, professional growth, program recognition, and networking. For more information about membership in ACDIS, please visit our website at www.acdis.org.