CDI Reviews by Specialty
Hello,
One of the specialty groups in our organization is asking for a CDI reviewer dedicated to reviewing neuro and stroke cases. Currently, the CDI Specialists review using 3M 360 Encompass Priority Scoring. I'm wondering if any organizations have CDI reviewers that are dedicated to reviewing specific specialties? If so, how is this set up as far as review process is concerned and do you have any words of wisdom or advice that may help us develop this? Thank you.
Jennifer Sens, RN, BSN, CCM
CDI Supervisor
Coding and Clinical Documentation Improvement
UC Health
Comments
Hi Jennifer,
Initial thoughts on your post are... why do they want to do this? Is it reactive to some kind of quality metric / public reporting... is it proactive and there is a goal in mind that their specialty group wants to achieve. Based on the why, perhaps this is an analysis to determine if a perceived problem exists.
Lets say you are tasked with doing this and not able to dig deeper. I would recommend first looking to your technology vendor, which in this case is 3M 360 Encompass and seeing how easily they can develop a swim lane for the cases to be reviewed. If that wasn't easily achieved, then I would look towards the reporting functionality in 3M 360 Encompass to pull the cases in a custom report.
Staffing resources are generally very limited and precious, so I would only allocate 1 person to work on those cases starting out. I would also try to establish some metrics ahead of time for exiting the project if it is not achieving the desired effect.
My advice is move slowly, allocate 1 resource, utilize your 3M 360 Encompass technology, don't disturb your current workflows. I would measure the project results against your current workflows and determine if the results were more beneficial to the organization than the Priority scoring you are using.
I hope that is helpful.
Feel free to reach out if you want to discuss further.
Thank you,
John Worthy, RN, CCDS
Director of Clinical Operations
jworthy@starauditing.com