Effective leadership goes beyond the numbers

I had the pleasure of participating in a panel discussion with the ACDIS Leadership Council on April 14, 2023. The topic of discussion was, “Optimized Comprehensive CDI Programs.” A nationwide ACDIS survey was conducted to understand the use and development of clinical documentation integrity (CDI) mission statements, metrics that departments use and report both within the department and those that are reported externally, as well as the use of productivity standards and what an optimized CDI program looks like. The panel reviewed and discussed the results highlighting key areas for discussion.   

With my background as a former CDI director and in my current role as a 3M CDI product specialist, I am passionate about the effective integration of technology into any CDI workflow to ensure an optimized program. While discussing key CDI metrics and productivity standards, as well as looking at the survey results from across the nation, it is evident that the need for data is key to success. Successful CDI workflows operate in tandem with a department’s technology to manage and obtain data. Many of the metrics focused on key indicators such as financial query impact, quality measures, case mix index (CMI) changes, denial rates and severity of illness/risk of mortality (SOI/ROM) scores, but the review rate metric remains a focus of many departments.  

As many departments are required to do more with less, the key to success is more about being able to focus on impactful reviews instead of focusing on how many cases can be reviewed. Performing reviews to meet a target metric just for the sake of meeting a coverage metric does not ensure that staff focus on reviews that yield the most impact, quality or financial. Leveraging technology to find and present cases with the highest chance of an impactful review in a worklist is crucial. Staff can then spend time on the cases that can yield a meaningful review instead of just reviewing cases by rote.   

While we might think a discussion around what an optimized CDI program looks like would focus on meeting key metrics and key performance indicators (KPIs), there was a much broader discussion on non-tangible factors specifically related to staff and leadership. We discussed how leadership is not just about the numbers, but about staff morale, satisfaction and effective management. The importance of finding the talent within your team and optimizing that talent was discussed as an important factor. I think that an optimized program includes a team that is functioning in a healthy way and is empowered to do their job well.  

Department optimization is not a static goal to be achieved and then abandoned. An optimized program is one that can shift when priorities are shifting, with a leader who is agile, forward thinking and that can use technology and tools to identify when those shifts need to happen, and to implement the technology and integrate staff and workflow to meet the new priorities.   

Chana Feinberg, RHIA, is a CDI product specialist at 3M Health Information Systems.