Clinical Documentation Improvement
Once solely a tool for ensuring maximum compliant reimbursement, Clinical Documentation Improvement (CDI) now also affects hospital quality profiles and physician scorecards, while providing a rich source of data to help lead hospitals in a fast-changing industry.
Prism’s experts, armed with decades of experience in CDI, nursing, and coding, will customize the tools you need to improve communication, engage healthcare providers, and monitor progress, so you can ensure maximum compliant reimbursement and advance quality immediately and well into the future.
There are specific criteria required to ensure your hospital produces an accurate medical record that describes both the level of necessary care and the high quality your providers deliver every day. Prism’s CDI consultants help hospitals strengthen their documentation programs to maximize opportunities in finance and quality through:
- Hiring, training, and retaining the brightest and the best Clinical Documentation Specialists (CDS’s). Our consultants understand how to competitively compensate, incentivize, and advance the best CDS’s. We provide classroom education followed by intensive mentoring, where we show your team how to write successful queries and effectively communicate with physicians. Further, by emphasizing the reconciliation of all cases, CDS’s will understand what they contribute by accurately recording key indicators, such as DRG (diagnosis-related group), SOI (severity of illness), and ROM (risk of mortality). Providing an accurate measurement of the value of a CDI program, from both a quality and financial perspective, can demonstrate its contributions to the broader organization.
- Engaging physicians. Incomplete physician documentation hinders coding and billing, and even small variations in medical record documentation can lead to lost compliant reimbursement as well as an inaccurate reflection of the resources used and the quality of the care provided. Prism will work closely with your physician leaders and medical staff to develop mechanisms to achieve effective and ongoing physician participation in CDI.
- Establishing metrics and monitoring outcomes. It is vital to identify a set of key CDI metrics that will be monitored on a routine basis to recognize and address unfavorable trends. The metrics should include tracking CDI Team productivity, physician engagement, and program results from a financial and quality perspective. Prism helps hospitals define and monitor the critical metrics that demonstrate the success of the CDI program. We coach CDS’s to leverage data so they can pinpoint opportunities for improvement. Prism also helps implement processes to facilitate more accurate and complete documentation, and we empower your team to immediately correct issues.
- Equipping senior leadership with dashboards and analytics. With clear evidence that financial benefits and quality scorecards trend up as the coverage rate and physician response rate improve, a top-down commitment to CDI from hospital leaders is essential to position organizations for success in the shift to value-based care. Prism works closely with clients to create compelling, organization-specific dashboards and analytics to demonstrate why a sustained focus on CDI is necessary to secure the most compliant reimbursement, improve quality ratings and support a healthy bottom line.
CDI can positively or negatively impact a hospital’s quality profile as well as its reimbursement and revenue. Prism coaches your CDI staff to become one team, dedicated to demonstrating each member’s hard work and to delivering a quality profile and bottom line that shine.
Ready to get started? Prism offers a complimentary diagnostic report to show you how your organization could benefit from revitalizing its CDI program.
Lisa Romanello, MSHI, BSN, RN, CCDS | July 2017
Webinar | June 21, 2017
The healthcare executive’s 2-minute read on priorities for 2017: Revenue cycle and clinical documentation improvement
Laura Jacquin, RN, John Storino and Nick Petrus | June 2017
Laura Jacquin, RN and Denise Tinkel, RRT, MHA, CCDS | October 2016