Health Information Management

Tip: Hire staff members based on expertise and professional passion

CDI Strategies, April 16, 2009

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Successful CDI programs begin with the selection of competent and cohesive teams. As CDI programs proliferate it becomes increasingly important to hire the candidate with the most appropriate professional experience. And CDI managers also need to pay careful attention to the personality of the candidate as well as their credentials.
First make sure candidates have the necessary experience, says Shelia Bullock, RN, BSN, MBA, CCM, manager of Clinical Documentation Services at University of Mississippi (Jackson) Medical Center. For the CDI program model that generally employs nurses, she says, “no new graduates. I want everyone on my team to have two-three years of clinical experience at a minimum, but I’d prefer to hire someone with utilization review or case management experience.”
While the CDI program model that incorporates both clinical and coding staff members is increasing in popularity, Colleen Garry, RN, BS, assistant director of clinical documentation for New York University (NY) Medical Center, says CDI specialists “have to have some coding knowledge.” She does not require specific UR/CM experience but does prefer to hire "straight from the staff nurse roll"
After hiring eight full-time and two part-time CDI staff members in November 2008, she took her new team through a comprehensive eight-week training program that included an overview of coding basics, MS-DRGs, and the CMS billing system.
“As you can see there are many ways to create a wonderfully successful team,” Gary says.
Outline your program’s strengths and weaknesses prior to posting your job opening. Then consider filling that open position with a person to offset those weaknesses and determine which talents best suit your organizations’ needs. If you’re looking for coding expertise to help you negotiate with the HIM professions, say so in your advertisements. Likewise, if you need a nurse with experience in nephrology to negotiate the differences between acute kidney injury and chronic kidney disease, say so.
The ideal candidate comes to CDI with four levels of expertise, says Lynne Spryszak, RN, CPC-A, Senior Consultant, FTI Healthcare, Inc., Brentwood, TN. These include the following:
1. Excellent computer skills. “We live in a technological age,” Spryszak says, especially with the new push toward electronic medical records and new electronic query programs entering the market. In addition, CDI staff members need to understand how to operate Microsoft Word, Excel, Windows, and Power Point in order to track query data and communicate results.
2. Clinical background. A solid understanding of clinical information is imperative, says Spryszak. “I look for strong Medical-Surgical background with a solid understanding of pathophysiology.”
3. Healthcare business knowledge. A CDI specialist needs to have a “wide view” of the healthcare industry, she says. So ask possible candidates about their experience with coding, billing, auditing, and various healthcare payers including CMS.
4. Communication skills. The intangible quality that takes a CDI program from good to great depends largely on each member’s communication and interpersonal skills. “I ask candidates to describe a situation of conflict from their last job, listen carefully to how they describe the situation, and watch their body language,” Spryszak says. “Our jobs always have some elements of conflict and I need to know how they will handle it.”
Editor’s note:ACDIS recently launched a job postings page for its members. Members can post up to four CDI-related positions at their facilities per year. Each post will remain on the board for 30 days. Non-ACDIS members can post openings for a fee of $150 per job description by contacting ACDIS member relations specialist Susan Calabro at, or by phone at 877/240-6586.

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