5 Strategies to Engage Physicians in Clinical Documentation Improvement Initiatives
Five Key Components for Building CDI Programs
According to a 2014 survey by ORC International, pay-for-performance or value-based reimbursement (VBR) is on the rise. The survey indicates that most payers and providers expect VBRs to overtake fee-for-service by the year 2020. This model mandates that reimbursements to hospitals and physicians be increasingly tied to the quality of care delivered. One of the most critical factors to accurately assess this is for physicians to precisely document the care they provide to patients.
Improving physicians’ clinical documentation skills is critical for any healthcare organization to survive in a value-based, post healthcare reform environment. Not only will it help sustain and maximize reimbursements, but the data it provides will help reduce compliance risk, minimize your vulnerability during external audits, and will allow you to troubleshoot quality of care issues.
Engaging physicians comes with its own set of challenges. Physicians are being asked to do a lot more than provide patient care these days. From Meaningful Use to ACOs, their participation is crucial to meeting a multitude of healthcare reform measures and organizational goals.
Add clinical documentation improvement (CDI) to the mix and healthcare organizations are faced with trying to accelerate a program that depends on the already time-crunched physician.
The good news is that hospitals can create an environment that streamlines the physician’s efforts and fosters participation by focusing on effective leadership, ample resources, and careful planning.
Here are five key components that are recommended for building an effective CDI program.
Your C-Suite Must Drive the Process
In order for physicians and hospital staff to make CDI a priority, the C-suite must drive the process by reinforcing the importance of an effective program and supporting the additional resources needed to make it happen.
When clinical, financial, and operational leaders show their commitment to the program, the message gets everyone’s attention. Leadership should take every opportunity to reinforce the importance of developing a successful CDI program and hold medical staff accountable for continuous improvements.
Commit to an Effective Budget
Developing and maintaining a CDI program will take physicians away from their clinical practice; therefore, they should be compensated for their time. The program should be comprised of physician advisors, CDI specialists, and coders, plus the training and technology needed to support the initiatives.
A realistic budget will make it easier to compensate physicians, hire additional resources, and invest in effective technology to facilitate the process. Calculating these costs into the budget will help ensure effective, long-term planning strategies.
Form an Executive Steering Committee
An executive council or steering committee should be at the helm of the CDI program. This group will set overall goals and objectives, communicate expectations, identify performance measures, establish a timetable, and define accountability.
The committee should develop policies for each area and make it a priority to continually educate, measure performance, and moderate the status and progress of the program.
Incorporate CDI into daily practice
Physicians have multiple distractions, with many non-clinical tasks claiming their time. Increasing productivity is best accomplished when the program is incorporated into a physician’s daily practice – with the help of support staff and a well-run EHR.
And, because physicians are typically not trained to develop documentation skills in medical school, hospitals and health systems should offer tools and resources that provide support in this area. Having CDI specialists and coders on staff will help minimize disruptions in day-to-day schedules.
Appoint physician champions
Identify the physicians in your organization who are already committed to CDI and are willing to step into a physician advisor role to help facilitate the process and provide enthusiasm.
Using physician champions encourages colleagues who are not yet on board. They provide credibility when communicating why CDI is so important to not only the hospital’s financial performance, but to also improve the quality of patient care. Physician advisors are particularly helpful in answering questions and helping to solve problems during the program’s development.
About the Author: Wendy Vincent, RN, is an accomplished healthcare executive with 30 years of professional experience across all areas of healthcare. She has served in both Executive and Senior leadership positions with academic medical centers, and large Integrated Delivery Networks (IDN’s) across the country. Wendy understands the unique opportunities and challenges associated with optimizing people, process, and technology. She has been successful with helping organizations identify areas to improve the quality of care, increase operational efficiencies, and optimize revenue.