Supercharge Your CDI

By Nick Tailhardat

Your hospital should be properly reimbursed for the care your team provides. One of the most effective ways of guaranteeing this is by improving documentation with the help of CDI Specialists.

However, understaffing is a common issue for many hospitals’ CDI teams, and often there aren’t enough available CDI Specialists to fill the roles needed.  Some of our partner hospitals have reported hiring lead times as long as 8 months when looking to fill one of these positions. On average, most CDI specialists are only able to conduct 16-24 reviews daily, which can make complete documentation for all cases impossible depending on your hospital’s daily census. Insufficient staffing can create gaps in information, leading to missed opportunities for reimbursement.

In order to most effectively utilize your CDI team and minimize the gaps in information created by understaffing, there are a few key strategies you can employ:

Utilize CDI Extenders

In the same way that physicians use extenders as liaisons to work more closely with hospital staff, extenders can be utilized for your CDI team. In many cases, admission volumes greatly outnumber the amount of patients who are capable of being seen by CDI specialists. Your CDI specialists can’t be in two places at once, so your nursing team can help fill in any gaps in information. Nurses can assist in bringing awareness to a changing condition or diagnosis, or initiate communication that increases the likelihood of identifying and documenting secondary diagnosis.

Involve Your Entire Team

CDI specialists should be active participants in unit huddles and physician rounding. According to a 2016 report, only 34% of CDI specialists participated in physician rounding, which can significantly restrict their access to patient information. Huddles and rounding are critical for discussing changes in patients’ status, and the information shared here verbally is often much more comprehensive than what is captured electronically. These meetings present situations where nursing can communicate vital information about status changes, which the CDI staff can then consider when reviewing documentation. In order to fully participate in rounding, it is key for CDI specialists to be on-site to communicate with nurses and physicians, as an in-person discussion facilitates a much deeper understanding of a patient’s condition.

Focus on the Most Complex Cases

Proper reimbursement for unusual or complex cases can be difficult when your CDI team is spread too thin. In order to accurately document these cases, CDI Specialists need to spend more time ensuring that a correct base DRG is assigned during admission and that complications are documented. More common diagnoses can be better communicated and documented by nurses and physicians, which allows your CDI team to do what they do best: focusing on the most complex patients.

Implementing these techniques can help your CDI staff maximize their efficiency and greatly increase their impact on your hospital’s reimbursement.