All Entries Tagged With: "networking"

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.” ~

Georgia ACDIS group set to meet

There’s less than three days left before Georgian clinical documentation improvement specialists converge on the city of Atlanta. And even though it’s their first meeting, organizer Bonnie I. Epps, MN, RN, manager of Clinical Documentation Improvement at Emory Healthcare, Inc., in Atlanta certainly hit the ground running.

Take a trip to Atlanta Friday for some CDI fun.

Friday’s meeting, which takes place at Dobb University Center at Emory University Hospital from 10:30 a.m. to 3 p.m., includes sessions on coding changes for 2010, RAC, and the physician’s role in CDI programs. Plus, Epps planned networking, door prizes, lunch, and a tally of results from an informal survey she conducted. That’s a lot to pack into a first meeting!

Since many participants will drive a long way, Epps planned the event for a Friday hoping to encourage a little extra tourist interest. “Hopefully many of you will take advantage of a trip to Atlanta to do some shopping and playing! I look forward to meeting you,” she said in her e-mail invitation.

The last time I was in Atlanta was just after undergrad. My girlfriends and I took a road trip from Boston to Atlanta. We’d originally aimed for New Orleans but thought better of it and settled for sightseeing the capitol of Georgia. One of my favorite memories was our visit to the Atlanta Botanical Gardens. If you have time, be sure to visit. An exhibit on display there now was ranked by TIME magazine as among the top 10 museum exhibits in the country!

Like Epps says: Come for the great CDI sessions, stay for a little shopping in the city, take a relaxing stroll through the Garden before heading back to your CDI program full of great ideas,  ready to go.

Northern Illinois CDI Network meets Nov. 5

Our friends in Northern Illinois have been gathering regularly for more than two years now, and

St. Alexius Medical Center is the site of tomorrow's IL meeting.

were a tremendous influence in the organization of the larger Association of Clinical Documentation Improvement Specialists.

I would be remiss if I didn’t give them a “shout out” about their meeting tomorrow. I am sure that the gathering at St. Alexius Medical Center in Hoffman Estates, IL, will be just as successful as all the earlier Prairie State meetings.

Here’s a copy of the agenda:

• Donna Kennedy- Compliance issues affecting CDI process
• Jonathan Becker- Monitor/measuring CDMP program
• EHR- Electronic Health Record- Impact on CDI
• RAC- discovery of clinical documentation queries
• Linnea Thennes and Colleen Stukenberg-ACDIS local chapter
• Working process between CDS and Coders working from home
• Misc

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.

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.

A Friday toast to lessons learned

Believe it or not there is an association for associations. And yes, Brian Murphy and I are soon to be members. Just as ACDIS provides a venue for CDI specialists to share best practices, the American Society of Association Executives (ASAE) and the Center for Association Leadership offers us helpful hints about how to help you. For instance, on the ASAE Blog “Acronym,” Brian Birch outlined a number of the valuable lessons he learned from his members.

I hope you can see where I’m going with all of this, my usual circular logic notwithstanding, since

'The Lesson' by Pablo Picasso. Don't we all have something to learn from one another?

what I’m hoping to convey is the power of circular learning. We all have something to learn from each other: The coder from the clinical experience of the nurse and the nurse from the regulatory understanding of the coder; the physician from the CDI specialist and CDI specialist from the specific knowledge of disease pathways locked away inside the mind of a physician.

So Mr. Murphy and I thought we’d put together a short list of items we learned from the members of ACDIS over the past few years. Things like:

• Once a nurse, always a nurse.
• Urosepsis is a four-letter word.
• Old physicians can learn new documentation tricks.
• Minutiae matters.
• It is easier to work with someone than for something.
• Be careful of the word acute.

And I think Brian Murphy and I learned the importance of the day-to-day work which CDI specialists pour their hearts into. As Mr. Birch wrote: “The best thing I have learned is that they are out there, professionals with strong minds and hearts who are just trying to make a better lives for themselves and their families.”

And so, a toast: To all the lovely lessons learned and all the casual teachers who have taken perhaps the briefest of moments to share their insights with me, their peers, and their coworkers. Please take a moment yourselves to post your own favorite lesson and give a shout out to the mentor who helped you most in the comment section below.

Minnesota CDI reflect importance of local gatherings

Minnesota may have 10,000 lakes but its CDI population hasn’t hit that highwater mark quite yet.

Minnesota's known as the Land of 10,000 Lakes. So far the lakes outnumber CDI but not for long.

Thanks to Michelle Callahan’s reservoir of good will, however, more than a dozen professionals turned out for the first Minnesota gathering of CDI,  Wednesday, September 16. Participants introduced themselves and talked about a variety of complex issues from electronic query systems to obtaining physician support for the CDI program. They talked about the function and form of the group and determined how the group might proceed with future meetings.

What particularly impressed me about the meeting wasn’t so different from what impresses me about other local ACDIS groups and CDI professionals individually— participants’ generosity.  Callahan, a registered nurse and lead clinical documentation improvement specialist over at Hennepin County Medical Center in Minneapolis, started collecting names and reaching out to nearby facilities to determine if there was enough interest in generating a group meeting. She volunteered to host the first session. She set up a meeting room, booked a conference line, and on the day of the gathering facilitated the conversation. During the meeting others shared their stories, talked about daily challenges and management successes.

It may not seem like much on the surface — an occasional meeting with others from your profession — but if you look at just the right angle under just the right light a universe of information is reflected back. Maybe the Land of the 10,000 Lakes doesn’t need 10,000 CDI, just the encouragement and continued participation of others in the area should be enough.

Mark LeBlanc, RN, CCDS, from Park Nicollet Health Services, hosts the next Minnesota meeting on October 28, 2-3:30 p.m. For information, e-mail Mark.LeBlanc@ParkNicollet.com.

Gather a harvest of networking opportunities

Time to harvest local chapter knowledge.

Up here in lovely Massachusetts the past few evenings there’s been a sweet chill. I’m talking about the kind of cold that actually makes us grumpy New Englanders happy. It’s also the kind of cold that gets the yellow jackets, especially those that hum around the orchard, buzzing.

Let me make another harvest-time allusion to say its not just the Cortland trees bearing fruit this fall. All the grassroots gathering and the local hard work seems to have generated a plethora of networking offerings for ACDIS members. I just thought I’d take a moment or two to let you know about a few of them.

Oregon
This coming Friday, September 18, 9 a.m. to 2 p.m., Oregon holds its first local ACDIS meeting. We are very excited and grateful to Linda Haynes, RHIT, CCDS, a documentation specialist at Meridian Park Hospital in Tualatin, for organizing what looks to be a very robust meeting. Registration and continental breakfast begin at 9 a.m., followed by welcome and introductions from 9:30-10:30 a.m. Haynes scheduled two presentations, one in the morning and one after lunch (which is on your own).  The group adjourns at 2 p.m. If you do plan to attend, please let her know as soon as possible by phone at 503/692-8864 or by e-mail at lhaynes@lhs.org.

Maryland
The Maryland CDS Workgroup meeting is also slated for Friday, September 18, 1:30-3 p. m., at the Maryland Hospital Association Headquarters in Elkridge, MD. For information contact co-chair Christine Mobley, RN, by e-mail at Christine.Mobley@dimensionshealth.org, or call 301/618-6507.

New Jersey
The NJ ACDIS Chapter meets September 25, 2 p.m., at Reimbursement Review Associates, Inc., 385 West Ferris St. Rte. 18 South, East Brunswick, NJ. But Deborah Gardner-Brown requests participants register by this Friday, September 18, so she can plan for the meeting. Contact Deborah directly for information at 732/238-4511 or by e-mail at dgardnerbr@aol.com.

Chicago CDI Boot Camp sold out

That’s the good news and the bad news, I’m afraid.

On the good news side of the scale we place the fact that 32 people—that’s right, 32 people—registered for the four-day CDI Boot Camp being held at the Marriott Courtyard in Chicago/Schaumburg September 28 through October 1. The number of registrants speaks to the intensity of the educational needs of the profession as well as to the dedication of CDI professionals.

Of course, on the bad news side of the scale we place the fact that the Chicago program is, in fact, sold out. So anyone in the area who had hoped to register but was perhaps waiting for last minute approval from their director or other supervisor missed out, I’m afraid. We hope that if you’re in Chicago and did get shut out of the Boot Camp, you’ll be able to take some solace in the fact that the 2010 ACDIS conference will be held in the Windy City June 3rd and 4th, with the pre-conference coding essentials program and post-conference CCDS exam.

Just one more item to tip the scale to the positive. (I like to leave things primarily on a positive note, if possible.) Just because the Chicago program is closed doesn’t mean there won’t be other learning opportunities. The Atlanta, GA, program taking place at Hyatt Place October 12-15, still has multiple open slots. Just a note on that, the early bird hotel room rate ends on September 18, so if you are interested you might want to mention that to the powers that be.  And the Boot Camp taking place at the Hilton Phoenix Metro Center in November from the 2nd to the 5th also has multiple slots open.

We are in the planning stages for the 2010 Boot Camp schedules now so if you want a session to come to your neighborhood, give us a shout. We hope everyone who attends the Chicago intensive has a great time and learns a lot.

Oregon Chapter to hold meeting in September

Two things happened in the Oregon town of Tualatian in 1951:

1. The Veterans of Foreign Wars (VFW) Hall that was built on Seneca Street.
2. The Tualatin River was inundated with crawfish.

So, the good people of the city did what most cities and towns would do, it threw a party and proclaimed it the first annual Crawfish Festival. The sordid history of the celebration includes a battle with Breaux Bridge, Louisiana, a town that proclaims itself the “Crawfish Capitol of the World.” At one point a self-proclaimed Voodoo Queen who lived in Breaux Bridge placed a hex on the Tualatian celebration. Although the hex (and a major riot in the 1970s) nearly ruined the festival the event neverless returned stronger than ever. An estimated 12,000 people were expected to join in the fun for the 2009 event which took place this past weekend August 7-9.

So while we’re sort of sorry the first meeting of the Oregon ACDIS Chapter has to wait until September 18, maybe its a good idea to avoid all talk of voodoo and crawfish when attempting to concentrate on the most appropriate documentation for malnutrition and congestive heart failure.

The meeting is slated for Friday, September 18, 9 a.m. to 2 p.m., at Meridian Park Hospital, 19300 SW 65th Ave., Tualatin, OR. Graciously accomodating those who have had their education and travel budgets trimmed, group organizer Linda Haynes, RHIT, CCDS, says she’ll have a conference line established for those who want to participate but can’t make the trip. If you do plan to attend, call her at 503/692-8864 or e-mail her at lhaynes@lhs.org.

I have no doubt there’ll still be some yummy crawfish for Oregonian day trippers to enjoy so come for the CDI information and stay for supper.