Value Added or Not-That is the question.
Just let me vent for a minute. We are a revenue producing program here at CDI. After much blood, sweat, no tears, I produced a sample of the the impact or interventions we have had both from revenue and quality perspectives. We have impacted SOI, improving it by 76%; ROM by 86%. And that is not with complete data yet for 2011. The comment back to me from a VP was, "Well at least you've paid for your salararies". So we are supposed to earn our keep so to speak. I understand ROI. But few departments or programs in a hospital are revenue producing and they do not get asked to earn their salaries back. I guess the fact that increasing the volume of patients who want to come here because of the demonstration of quality patient care isn't REALLY worth all that much. Okay, now talk me down please. I'll say thanks in advance. Donna
Comments
Your not alone! What I have come to realize is to take what is said from
the role of the person who said it. For example: finance will talk dollars
to you, that is what they know. Quality department will scoff at the
dollars and stress the importance of quality, HIM really just want the
charts coded accurately and to avoid denials. Where are we? right in
the middle of it all!!! As a nurse, I could NOT do this job if I did not
feel that I was making a difference in patient care, as a supervisor--- it
is the numbers I need to report to obtain additional funding and staff
..... as a student in the HIM world -- I just want to understand!!!!! So
please, vent away!!! You are not alone ..... When my kids were small and
they would ask how can a person be so mean, or rude, I would tell them to
look at that person as having a disability. Instead of getting angry, feel
bad for them. So, when someone talks money at you, feel bad for them
because they lack the knowledge to understand what it is you do every day
--- Make patient care better, every patient every time!
Thank You,
Susan Tiffany RN, CCDS
Supervisor Clinical Documentation Program
Guthrie Healthcare System
phone: 570-887-6094
fax: 570-887-5152
email: tiffany_susan@guthrie.org
"Twenty years from now you will be more disappointed by the things you
didn't do than by the ones you did do. So throw off the bowlines. Sail
away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
Discover." Mark Twain
I love your statement "Instead of getting angry, feel bad for them. So, when someone talks money at you, feel bad for them because they lack the knowledge to understand what it is you do every day --- Make patient care better, every patient every time!"
Donna Kent, RN, BSN, CCDS
Manager, Clinical Documentation Integrity Program
Clinical Quality and Accreditation
Torrance Memorial Medical Center
ph.:310 784-6884 fax:310 784-6899
donna.kent@tmmc.com
What I've always advocated is education. Two years ago I received permission to attend the nursing manager's forum to present on our program, and to attend unit staff meetings on a rotating quarterly basis to do the same. Unfortunately, I am expected to continue as a staff CDI with a full work load while developing the content and presentation, etc., developing new tools, working with the MDs on new forms that will facilitate their work and ours, etc. There simply are not enough hours in the work day. For 10 years I've worked at home on weekends and stayed over an hour or two each day to do the things that I think are important to having a quality record to support quality patient care. I agree that I'm still a nurse can have an impact on patient care and quality.
There will ALWAYS be an expectation and a measurement of your financial impact. The secret is what other metrics can you provide and how you disseminate that information to the staff, physicians and hospital leadership. I continue to work toward discovering the answer to that secret!! My current project is setting up an entire CDI compliance program that will also provide some metrics for us. I'll keep all of you posted as it is a work in progress. I have the rough design and have the initial reports designed and built by IT. Now we have to actually do the audits so I'm working on tools to support inter-rater reliability. My point is that I'm hoping this provides us with a look at the work we do that is not entirely focused on dollars but on quality and compliance.
Thanks for the use of the soapbox, Donna. I'm done now!! NEXT?
I suggest there are few if any other roles within the organization that have such a varied skill set & knowledge base.
The CDS is at a unique intersection.
Donna -- sounds to me like you are doing the right things to make progress towards convincing your organization of the multiple effect of the value you bring. Good job!
Don
affirmation from your colleagues. It really does make a difference.
Donna Kent, RN, BSN, CCDS
Manager, Clinical Documentation Integrity Program
Clinical Quality and Accreditation
Torrance Memorial Medical Center
ph.:310 784-6884 fax:310 784-6899
donna.kent@tmmc.com