These days, clinical documentation improvement is on everyone's mind. As hospital's focus on ramping up documentation to prepare for ICD-10, the demand for CDI specialists continues to grow. In fact, more than 80 percent of all hospitals will have a CDI program by 2014, according to a recent AHIMA study.
However, finding the best CDI candidate may be easier said than done, and it certainly requires careful consideration. Hospitals must hire someone who fits in both personally and professionally with a variety of other individuals. The good news is that an experienced and thoughtful CDI specialist can work wonders for your hospital. Improved data quality, accurate reimbursement, better patient care and enhanced coder productivity are just a handful of the many benefits a facility can gain when hiring such an individual.
Consider the following tips for recruiting a CDI specialist:
Tip #1: Cast a wide net both internally and externally
When searching for a CDI specialist, you may want to first consider promoting a coder, HIM professional or nurse/case manager internally. One advantage of this is that these individuals may already have a rapport with physicians and can more easily transition into the role.
Hiring externally is always an option, and it would likely provide a larger pool of candidates from which to draw. External candidates may also have a fresh perspective that can be helpful in achieving new goals or taking your CDI program in a new direction. These individuals can enter your CDI program and be mentored by a current specialist who already has familiarization with the hospital, its providers and the overall workflow and environment.
The Association for Clinical Documentation Improvement Specialists offers a job board on which hospitals can post various positions. Social networking is also a great resource. LinkedIn, a professional networking website, allows users to connect with other professionals, including many CDI specialists, as well as participate in discussion forums and post jobs. A third — and perhaps most efficient — option is to work with a recruitment firm — particularly one that specializes in CDI specialist placement. These firms have a solid understanding of the industry and are constantly networking. They often have lists of professional contacts and a solid selection of qualified candidates.
Other methods to recruit qualified CDI specialists include but certainly aren't limited to the following:
- Network internally and get to know staff from various departments
- Network with local universities
- Network and post positions at trade association meetings
- Advertise online and in a professional journals
- Referrals — ask current employees to assist in recruitment strategies and ask for physician referrals
AHIMA published a CDI Toolkit that includes a sample CDI specialist job description (see p. 8) that hospitals can use when advertising for an opening or as a starting point to build their own.
Tip #2: Credentials aren't the only indicator of a candidate's strengths
A CDI specialist should ideally possess one or more of the following credentials: registered nurse, certified coding specialist, registered health information administrator, registered health information technician, certified clinical documentation specialist or certified documentation improvement practitioner.
Hospitals definitely want to hire someone who understands coding concepts, guidelines and clinical terminology as well as anatomy and physiology, pathophysiology and pharmacology. They'll also want someone who can read and analyze all information in a medical record. Some hospitals may choose to hire all clinical staff and train those professionals on coding and compliance guidelines. Other hospitals may hire all HIM professionals with strong clinical knowledge. Some may hire a combination of HIM and clinical professionals.
Regardless of the structure of the CDI program, candidates should also possess these important traits:
- Excellent verbal and written communication skills — someone who can communicate effectively with physicians
- Strong leadership skills — someone who can take charge to educate physicians and other clinicians proactively
- Persistence — someone who can build rapport with medical staff and help them overcome any resistance to change in a professional and respectful manner
- Initiative — someone who will take the time to perform necessary research and understand the bigger picture of how documentation relates to audits, quality measures, reimbursement, medical necessity and more.
- Well-roundedness — someone who can work well when teamed up with others as part of a hybrid staffing model (i.e., HIM professionals, nurses, physicians and other healthcare professionals with a clinical or coding background) or a multidisciplinary staffing model (i.e., RNs, physicians, physician assistants and HIM professionals all review the health record concurrently and communicate with providers) to enhance documentation specificity.
Tip #3: Get the know the candidate
When interviewing candidates, be sure to include key stakeholders, such as coders, other members of the CDI team, nurses and your physician champion. A physician champion can offer valuable insight into which candidates would work well with physicians and most easily obtain buy-in.
Ask open-ended questions during the interview. These types of questions can really give you a sense of how the candidate communicates, handles stress, and more. Consider the following:
- Tell me about your leadership skills.
- How have you handled conflict in the workplace in the past?
- How might you go about obtaining physician buy-in?
- Can you share an example of how you've motivated others?
Testing candidates is also an option. A formal test should include a combination of both clinical and coding questions. However, don't base a candidate's entire interview on his or her test results. Consider the test as well as the interview, team feedback credentials and references when making a final decision.
AHIMA has published an article titled "Recruitment, Selection, and Orientation for CDI Specialists" that provides helpful information about recruitment best practices, skill-based selection testing, interview tips and more.
Kayce Dover, MSHI, RHIA is a Health Information Management professional with a master’s degree in health informatics. She has worked in the HIM industry more than 15 year and has focused much of her career on the recruitment and staffing of HIM professionals. She currently serves as president and CEO of HIM Connections, an expert recruitment and staffing firm for health information management professionals and CDI specialists.