Health Information Management

Q&A: ACDIS advisory panel members answer questions about chart reviews, staffing

CDI Strategies, October 30, 2008

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Are there any standards about how many records to review per day? How about staffing size?
 
Lynne Spryszak, RN: At my facility we average about one CDI specialist for every 2,100 annual Medicare discharges. I would recommend 1:1,700-1,800 annual discharges when you consider other duties that may be involved, such as data management and reviewing information for other programs (core measures, present on admission, etc.). Also, consider whether your hospital uses a hybrid record and what types of tools your CDI specialists use (e.g., a database, laptops, etc.), as well as your program’s goals.
 
Gloryanne Bryant, RHIA, CCS: There are no true standards but what we see and hear is about 25-30 records per day. You may find that the inpatient census is high on Mondays and then many patients get discharged on Fridays.
 
Robert Gold, MD: There are no standards, just anecdote. When you have the wrong personnel doing the job, when CDI specialists are trained the wrong way or work in a program that does not get directed to the medical staff (and is instead aimed at the medical staff), or if you don't implement a clear process to support the CDI specialists' needs, your numbers will suffer and your outcomes will be inadequate. With sufficient numbers to see 40-60 records a day (with 10-15 of those being revisits), you'll do just fine.



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