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CDI and Quality Care Measures Boot Camp

COURSE
HC Pro
9 hrs

CDI and Quality Care Measures Boot Camp

COURSE
HC Pro
9 hrs

Library Overview

The CDI for Quality Boot Camp Online is an intensive course designed for CDI departments/programs looking to move to the next level of CDI—not just diagnosis review and clarification, but how diagnoses impact hospital quality metrics and influence indirect revenues. This course covers publically reported quality data and how code assignment affects quality metrics, including but not limited to the Hospital Value-Based Purchasing Program. Students will learn the why and how of reviewing complex cases involving Patient Safety Indicators (PSI) and hospital-acquired infections (HAI), and gain measurable strategies for improving their hospital profiles and positively influencing their facility’s value-based incentive.

Library Objectives

Upon completion of this program, the participant will be able to:

  • Define payment methodologies beyond Medicare’s inpatient prospective payment system (IPPS), including the Hierarchical Condition Categories (HCC) system
  • Describe the potential advantages and documentation opportunities of expanding CDI beyond MS-DRG review/optimization and CC/MCC capture
  • Explain the impact of principal diagnosis assignment (i.e., diagnosis sequencing) on indirect revenue, including that affected by quality metrics and medical necessity denials
  • Define the CDI specialist’s role in supporting medical necessity and working collaboratively with utilization review/case management
  • Develop documentation strategies to enhance a hospital’s quality metrics without compromising data integrity congruent with official coding guidelines
  • Describe how additional CDI responsibilities impact individual metrics, including staffing, productivity, and workflow
  • Discuss how physician documentation impacts various quality metrics through coded data, compared to abstracted data and surveillance data
  • Conduct reviews and/or develop appropriate review processes to ensure accurate reporting of Patient Safety Indicator (PSI) 90
  • Develop strategies to leverage collaboration within the revenue cycle, including CDI, coding, infection control, quality, and case management (utilization review) to promote consistency in the reporting of metrics associated with Hospital Value-Based Purchasing (HVBP) and other quality indicators

Contributor Bio

Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, is the CDI education director with HCPro. Prescott serves as a full-time instructor for the CDI Boot Camp as well as a subject matter expert for the Association of Clinical Documentation Improvement Specialists (ACDIS).Prescott is a frequent speaker on HCPro/ACDIS webinars and author of The Clinical Documentation Improvement Specialist’s Complete Training Guide. She started her nursing career in 1985 as a graduate of the University of Vermont School of Nursing. Since that time she has worked at a variety of organizations, including academic, large, and small community hospitals. She has worked in a number of nursing roles, including as manager in the areas of medical/surgical, ICU, PACU, and endoscopy. Her experience also includes specialization as a compliance officer.

Audience

Who should attend?

  • CDI specialists, CDI supervisors, CDI managers/directors
  • Quality improvement professionals, quality department managers/directors
  • Coding supervisors, coding managers/directors
  • HIM managers/directors
  • Coding compliance specialists, coding compliance supervisors/managers/directors
  • Utilization review/case management managers/directors
  • Revenue cycle managers/directors
  • Physician advisors/champions to CDI
  • Hospitalist leadership

Accreditation Statements for the library as a whole

NOTE: Credits are only offered after completion of all courses and the final exam.

American Health Information Management Association (AHIMA)
This program has been approved for _8_ continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).​

Accreditation Council for Continuing Medical Education (ACCME)
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.HCPro designates this educational activity for a maximum of _10.5_ AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Comission on Accreditation.This educational activity for _10.5_ nursing contact hours is provided by HCPro.

Association of Clinical Documentation Improvement Specialists (ACDIS)
This program has been approved for _10.5_ continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Improvement Specialists (ACDIS).

California Board of Registered Nursing
HCPro, is approved by the California Board of Registered Nursing to provide _12.6_ nursing contact hours. California BRN Provider #CEP 14494.

Commission for Case Manager Certification (CCMC)
This program has been submitted to The Commission for Case Manager Certification for approval to provide board certified case managers with _8.5_ clock hours.

Learning
Library Contents
Introduction to Healthcare Data and Public Reportinginteractive
Introduction to Diagnosis & Procedure Coding and Data Collectioninteractive
IPPS and MS-DRGsinteractive
Introduction to Quality: CMS Quality Initiativesinteractive
Risk Adjustment in Qualityinteractive
Hospital-Acquired Conditionsinteractive
Hospital Inpatient Quality Reportinginteractive
Hospital Value-Based Purchasinginteractive
Hospital Readmissions Reduction Programinteractive
Patient Safety Indicatorsinteractive
Healthcare-Associated Infectionsinteractive
CDI Process & Compliant Queryinteractive
Final Examinteractive