Health Information Management

Avoid burnout and ease stress: Strategies every HIM director and manager should know

JustCoding News: Inpatient, April 11, 2012

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It's 2:30 p.m. and you haven't stopped moving since you stepped into your office this morning.

As you run down your mental to-do list for the rest of the afternoon, you realize you're double-booked for multiple meetings, and you're having trouble prioritizing because your phone keeps buzzing with new e-mail notifications.

If you're a health information management (HIM) director, this scenario likely repeats day in and day out.
From researching and implementing electronic health record (EHR) systems to developing training and education plans for ICD-10 to overseeing your Recovery Audit Program review results, the daily tasks of an HIM director can quickly become overwhelming.

In the past year or two, Monica Pappas, RHIA, president of MPA Consulting in Long Beach, CA, and MRB advisory board member, has noticed a drastic increase in the amount of major projects overseen by the HIM department. And many of these projects have far-reaching effects that impact the entire organization, compared to times in the past when projects may have had a more limited effect.

Pappas points to HIPAA implementation as the most recent project spearheaded by HIM that mirrors the organizationwide effects of EHR implementation and ICD-10 conversion.

The difference between HIPAA and these new initiatives is that HIPAA came about during a relatively calm period for HIM, whereas multiple projects are currently due to launch around the same time.
That said, the projects must get done, which means HIM professionals need to be at their best.

So MRB asked Pappas and two other HIM professionals for their advice on how they handle their busy schedules and what they do when the pressure becomes too much.

Reach out to professional peers and resources

Pappas finds professional organizations such as the American Health Information Management Association (AHIMA) or state HIM organizations provide excellent tools and resources that HIM professionals may adapt for use in their own organization.

She recommends taking the time to research training modules, job descriptions, and policies and procedures that you may be able to use to fill gaps in your department.

Pappas also suggests reaching out to your fellow HIM professionals—they may have already formulated the policies you wish to develop.

"If I see someone else's policies and procedures, I can take 20 minutes to adapt them as my own," she says. "It gives [HIM professionals] a jumping-off point rather than starting from scratch."

It's when HIM directors don't have a plan that they can feel the most frustrated, she notes.

Pappas stresses the importance of talking to your manager if you are feeling overwhelmed. "It can't all be negative, but if you don't give some warning signals, you won't get help," she says.

Help may come in many forms, from contracting with a vendor to take over a project or hiring temporary support staff to alleviate some of the burden.

Asking for help is not a sign of weakness, says Pappas, and the consequences of not asking for help can be far worse than the perception of weakness.

It's also critically important to recognize what you have managed to get done versus focusing on what remains, says Pappas.

She suggests breaking down projects into smaller, manageable tasks and formally scheduling those tasks into your calendar. In doing so, HIM professionals will be able to manage the set due dates for each step of their projects.

Use Outlook for more than just e-mail

Patti Reisinger, RHIT, CCS, HIM director and privacy officer at County Medical Center in Missoula, MT, is currently overseeing the implementation of a new EHR system, monitoring the Recovery Audit Program audit process, and working on ICD-10 education and training—in addition to her day-to-day responsibilities of overseeing the HIM department.

Reisinger finds using her Microsoft® Outlook® calendar to schedule and track her meetings helps in managing her hectic schedule.

"I use Microsoft Outlook for everything to do with my professional life," she says.

Additionally, Reisinger uses Outlook's tasks feature to keep a virtual to-do list of all her deadlines and assignments.

As e-mails come in that need attention, she prioritizes them using Outlook's flags and follow-up features to keep order within her inbox. And with the large volume of e-mail she receives every day, having a system in place helps ensure important messages are not lost in the shuffle.

Reisinger even uses her Outlook calendar to make sure she builds in a bit of time for herself.

"Schedule your noon hour in Microsoft Outlook for your lunch," she recommends.

She says people looking to schedule meetings will take any available space in your calendar, so blocking out that time will ensure you have a much-needed break between meetings and deadlines.

Reisinger also recommends taking time away from your desk, even it is just for five minutes. "I stress to my staff to take breaks. Take time away from your desk and away from the office," she says.

For example, when Reisinger needs a quick break, she may take the long way back from the hospital cafeteria after lunch or, when the weather permits, goes for a brief walk outside.

Even five minutes away from your desk can provide enough of a mental break to alleviate stress and get refocused, she says.

Delegate responsibilities to your staff

Tesa Topley, RHIA,
director of HIM and privacy officer at Providence St. Patrick Hospital in Missoula and St. Joseph Medical Center in Polson, MT, is also in the process of implementing an EHR system and managing ICD-10 education and training.

She finds delegating certain responsibilities to her staff mutually beneficial.

Specifically, she says that the EHR rollout has led to 10–14 hours of conference calls per week, plus internal meetings.

"I've reached out to my staff and asked them who wants to work on each initiative and participate in these phone calls," she says. "It's helped them understand that these changes are coming, and they get to feel some ownership in the changes."

Topley has shifted much of the responsibility for ICD-10 training and education to her coders.

She has already sent four of her coders to an AHIMA Train-the-Trainer seminar and each of those four actively participate in ICD-10-related phone calls.

"I've really put the ownership on my coders and they love it," she says.

Topley finds the collaborative environment extends beyond just those whom she has chosen to participate in the new committees and initiatives.

Those employees not directly involved have stepped up to cover the day-to-day responsibilities of the department. This has freed up time for those who spend some of their time on the special committees.

"Rely on your staff. They are experts in their domain, so let them be the experts," says Topley.

Relinquishing that bit of control will allow you to focus on other areas that need your attention.

If all else fails, what does Topley recommend? Buy a coloring book. "When I get home, I have two little boys, so we are always doing something like playing Nintendo® Wii™ or coloring. You work to live, you don't live to work," she says.

Editor’s note: This article was originally published in the April issue of Medical Records Briefing. E-mail your questions to Senior Managing Editor Andrea Kraynak, CPC, at

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