Pediatric CDI Staffing
Hi everyone,
How do you all determine the most appropriate CDI staffing levels for your pediatric programs? What productivity measures do you use?
Thanks,
Jenn Burkett
Hi everyone,
How do you all determine the most appropriate CDI staffing levels for your pediatric programs? What productivity measures do you use?
Thanks,
Jenn Burkett
Comments
For our Pediatric Reviewers I utilize the same KPI expectations as adult reviewers. Review Rate 20+ per day on average, query rate at least 25%. I have two CDI Specialists for my peds hospital and they have no issues in meeting these goals. Facility review rate is at 100% currently, query rate at 35%, provider agreement rate not at goal, however average for March was 81%, and response rate 100%. Hope this helps.
I always answer this question the same way....depends. For example, if your hospital has a predominantly APRDRG population, these review and re-reviews are much more labor intensive, especially in the re-review and query aspect since many things can affect SOI, but in MSDRG it is much more cut and dry. To hold the same standard for that reviewer as someone who is reviewing a primarily Medicare population does not make sense to me. This is an administratively simpler way to handle CDI productivity; however, I would say it does not tell the story. For the sake of example....
I practice in a state that held a state-specific grouper until mid-2023. During that year, my overall metrics seemingly dropped the second half of the year due to the conversion of that grouper to APRDRG leaving about 85-90% of the population reviewed as APRDRG. This is a vastly different workload so the metric in 2024 reflected that more significantly being the first full year where the change was implemented. While the cases reviewed were less the revenues attributed to the reviewer were higher.
Not to get too deep into the weeds with the answer, but just to demonstrate that it may be working fine to apply things universally across the board amongst adult and pediatric reviewers and different hospitals, but that may be a function of the demographic from an insurer perspective. I would also take care to collaborate with reviewers so that they are not just meeting the metric and missing the mark- so to speak.
Just some thoughts on this popular topic....