The vision
A regional medical center wanted to improve its quality ratings and identified clinical documentation integrity (CDI) as a critical focus area. The goal was to ensure documentation accurately represented the high-quality care provided. This in turn would boost quality ratings and head off avoidable claim denials and downgrades. But its retrospective documentation program required a redesign and hands-on implementation.
Co-creating the solution
The medical center partnered with Chartis to perform an onsite assessment and redesign its CDI program. Collaborating with CDI staff, key improvements included refocusing CDI reviews and provider engagement, reassigning health information management (HIM) audits to appropriate personnel, and implementing standardized review templates. The team defined staff roles, including a new CDI lead role for enhanced oversight. They also optimized technology to improve case assignments, query management, and ROI tracking.
Believe in better
Now, the medical center leverages real-time queries that support quality care. Streamlined, tech-enabled workflows increase the CDI team’s productivity as they focus on high-impact reviews (e.g., DRG reassignment, PSIs, mortality) and concurrent stays. A monthly education plan includes in-person training and support to equip staff for success. The revamped CDI program is on track to reduce claims denials and downgrades, decrease quality variability, and drive strong performance in rating and rankings programs.
