In January 2016, a large Pennsylvania-based regional referral center and teaching hospital added five specialists to its clinical documentation improvement (CDI) team. The new hires needed appropriate education and training to build a strong foundation, ensure they were ready to join the hospital’s CDI staff, and be as productive as possible right from the start.
Having previously assisted the hospital with setting up its CDI program, Guidehouse was again contacted to help prepare the specialists for their new roles. Guidehouse provided on-site CDI education and mentoring for the specialists, customized to the needs of the hospital. Each specialist received one week of classroom training and three weeks of shadowing/mentoring of chart review. The approach helped ensure specialists have an understanding and ability to identify and process principal and secondary diagnoses, MS-DRG assignment, and situations when a physician query would be necessary.
In addition, Guidehouse collaborated with the hospital’s CDI leadership to tailor training to the skill level and background of the specialists, the top DRGs treated at the facility, and the most prevalent query opportunities identified. The training also focused on compliance queries and appropriate ICD-10 coding.
The specialists gained a comprehensive understanding of underlying regulations, guidelines, and compliance rules that govern CDI services. As a result, the hospital’s CDI program has developed into a sustainable program with the flexibility to adapt to the ever-changing healthcare environment, yielding an annual financial impact of more than $5 million for the hospital.