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Raising the Bar: Strategies for Elevating CDI in Your Organization

2/28/2024

Each fall Iodine hosts a client symposium, Iodine Connect, bringing together leaders in CDI, UM, and Revenue to share insights, expertise, and strategies for tackling some of the biggest challenges facing healthcare providers. For this month’s episode, we’re sharing an excerpt from one of this year’s Iodine Connect sessions on implementing new tools across your healthcare organization. Listen to Episode 18 Raising the Bar: Strategies for Elevating CDI in Your Organization to learn more.

Clinical Documentation Integrity (CDI) departments play a crucial role in the functioning of hospitals and health systems, impacting areas such as reimbursements, denials, and quality rankings and community reputation. Despite their integral role, the understanding and recognition of CDI’s importance within organizations can sometimes be lacking. In this episode Iodine’s Chief Clinical Strategist, Fran Jurcak, is joined by Tess Tolentino, CDI Manager at Hendrick Health, and Cleopatra Hyman, Director of Case Management and CDI at Children’s Nationa Hospitall, as they discuss strategies for elevating your CDI program with your organization.

Physician Education and Buy-in:

One key strategy discussed in the episode is the importance of physician education and buy-in. Children’s National Hospital, for example, conducts monthly workbook meetings with data analyst teams, breaking down physician performance by service line. This data is then shared with physician champions and attendings, tapping into their competitive nature by showcasing financial contributions and opportunities for improvement.

Hendrick takes a similar approach by providing Continuing Medical Education (CME) to physicians, incentivizing attendance with CME ethics credits. 

Fran Jurack echoed the importance of physician champions, stating “The thing that I find fascinating is everything that you all brought to the table as a way to gain growth, or knowledge, or just a general understanding of what CDI is doing for the organization, was actually through your relationship with physicians. When you get your physicians engaged and involved in your champions, they’re out there actually helping you kind of sell CDI to the rest of the org.”

Leveraging Metrics

Another critical aspect emphasized in the discussion is the use of metrics to demonstrate the impact of CDI efforts. At Children’s National Hospital, CDI reports up to the CFO and each month they present provider-specific data on physicians. By showing them what was documented, when CDI reviewed it, and the potential outcomes without CDI intervention, physicians become more interested and engaged.

“Look, this is what you documented. Here’s when CDI reviewed it. If we didn’t review it, here’s how it would have gone out the door. And they’re like ‘Wow.’ And that makes them interested, ‘Hey come teach me, I want to do better.'”
Cleopatra Hyman, Children’s National

Hendrick shares similar success. While in the beginning, they struggled to be included on various committees to ensure they had input, not they have to turndown invitations because so many rely on CDI and their metrics. Tess Tolentino runs a reports every month with key metrics that she shared with Hendrick’s CEO, CFO, and Utilization Management (UM) team. As Tess stated, “It’s a great feeling when you hear them say “Our PEPPER report is great thanks to the hard work of CDI.”

Getting in Front of People

Finally, the value of simple getting in front of people cannot be ignored for improving CDI’s visibility within an organization. Tess described just stepping up and introducing herself to those who didn’t know CDI and what they were about, and in the past she has lobbied to be both part of Hendrick’s compliance committee, and included in the CMO’s monthly medical staff newsletter. “And it worked.” says Tess, “We contribute every month, whatever the hot topic of the month is. There’s new malnutrition, that’s a big opportunity for us, and Iodine is helping us. So now I provide them with the trend, this is our baseline and this is how we’re performing now with queries and stuff.”

Elevating a Clinical Documentation Integrity program involves a multi-faceted approach, with education, metrics, and visibility playing key roles. By engaging physicians, leveraging metrics to showcase the program’s impact, and actively participating in organizational initiatives, CDI departments can strengthen their position within hospitals and health systems, ultimately improving overall healthcare quality and outcomes.