On September 9, 2021, Rita Parmar, CDI community facilitator, led the quarterly clinical documentation improvement (CDI) community meeting. The focus of this meeting was on the sharing of ideas and resources to engage leadership teams and physicians.
Through presentations, discussions, and polls, the participants discovered opportunities to share successes and more effective pathways to CDI implementation across the board.
The discussion began with a recap of CDI Week 2021 and a sharing of resources from participants. One was a video on the importance of a well-structured CDI program and stakeholder engagement.
One participant shared their experience of implementing a CDI program, underlining its hybrid but transformative progress, as the group considered the evolution of documentation from paper to electronic. A participant raised a question about the advantage of computer-assisted coding and the implementation of Codefinder. Responding to this, another participant highlighted the use and deployment of Codefinder and CAC by the health authorities of BC’s lower mainland. One person noted a difficulty in implementing CAC due to the scanned documents.
The group suggested prioritizing stakeholder engagement over the strengthening of a CDI program as a more proactive approach. More than half of the participants (67% from the poll result) expressed the desire for more engagement with leadership teams. The group also identified the following opportunities to foster stakeholder engagement:
- Presentation of a CDI program value at medical advisory committees
- Frequent one-on-one query processes
- Engagement with patient quality and safety teams
- Steering committees with Hospital Harm and Hospital Standardized Mortality Ratio (HSMR)
- Onboarding new physicians
- CDI specialists attending more rounds with physicians
- Education pamphlets
The group also identified the importance of follow-up conversations around CDI implementation, especially with new staff. As an incentive to adopt CDI, participants suggested that credentialing be connected to CDI implementation. This credentialing (based on HIG weight scores) could lead to healthy competition between physicians, resulting in completed charts and accurate documentation.
To end the community meeting, seven participants volunteered to join a working group to create an adaptable template to engage physicians and reinforce the importance of CDI.
