In CDS Snapshot, we're profiling CDSs from across Australia and ICD-10-AM countries. We'll get to hear how they got into the role, their triumphs, and challenges they've faced. CDSs contribute enormously to patient safety, quality of care, health service sustainability, and CDI as a whole, and we want them front and centre!
This week, we hear from Kerrie Ebbutt, CDS and Case Manager at Sydney Adventist Hospital in Sydney, Australia. Hear how Kerrie's role involves collaboration and communication between many stakeholders across the hospital to improve communication and process issues relating to clinical documentation.
Tell us about your current role.
I am the Cardiac Case Manager, and case manage a general medicine/respiratory medicine ward also at the Sydney Adventist Hospital (“The SAN”). I work part time in clinical documentation improvement with the hospital CDS.
What is your career background, and how has that contributed to your ability to work as a CDS?
I trained at Royal Prince Alfred Hospital and have a Bachelor of Health Science, and a post graduate hospital-based certificate in Cardiothoracic Nursing. I worked in Cardiothoracic ICU for several years, relieving in the position of Nurse Educator regularly, before moving into Cardiac Patient Education. I have worked at Liverpool Hospital Sydney CICU and Strathfield Private Hospital Sydney CICU, as well as working for a Critical Care agency in Sussex, UK for a year. I have been in my Case Management role for several years at the SAN. My critical care knowledge has been helpful working as a CDS, in addition to my well established relationships with the many doctors and other clinicians which is helpful when raising CDI queries and educating colleagues.
What made you apply for a CDS role?
My Case Management role at the SAN changed following an organisational change three years ago, and CDI became part of the Case Manager role. We received excellent education and thus began my interest in CDI. I welcomed the change and was asked to work with the newly appointed CDS about 18 months ago.
What does your typical day look like?
Typically in my day I am reviewing patient records looking for CDI opportunities and attending planning meetings with the CDS, meetings the Executive, Patient Services, Medical Records, education to other Clinicians, Information Services- all with the aim of resolving process and communication issues to improve documentation.
What was the moment when CDI really “clicked” for you?
When we witnessed the results of retrospective audits on patient records and saw the queries that were raised, the role of the Case Managers in following up with the queries at that time, and successfully seeing the records recoded with DRG optimisation was very satisfying as well as a great learning opportunity.
How would you describe your personal CDI philosophy?
My personal CDI philosophy is based sincerely on improving the medical record to communicate better with all the clinicians involved with the patients journey and to improve safety and care. However, the CDI program success is measured by revenue improvement which I also understand is vital to the ongoing funding of the roles. This in a way has been the biggest challenge I have faced as a CDS, as we have demonstrated significant improvements in capturing ICD-10-AM codes, but the metric used to demonstrate the DRG upcoding as a result and subsequent revenue improvement has had its limitations.
What is the biggest challenge you have faced as a CDS?
Some documentation queries have been easy and documentation added on first request, while others have required several follow-ups and unpleasant interactions with a clinician at times. On the occasions that the latter has resulted in a clear DRG change, the angst has been really worth it!
If you could talk to yourself 10 years ago and tell them you’re now a CDS, what do you think they would say?
If I could talk to myself 10 years ago and tell them I am now a CDS, it would confirm to me what a great choice of career I have made in Nursing and as I expected, interesting and satisfying job opportunities have indeed arisen.
Favourite DRG?
My favourite DRGs are the cardiac surgical DRGs of F04 to F06 because they are my favourite patients to nurse and where my knowledge is.
Favourite additional diagnosis?
Favourite additional diagnosis? Hmmm- I would say post haemorrhagic anaemia because with the open heart patients, it is not uncommon, and yet still so poorly documented.
What are you excited about in the future of your role?
I am excited about presenting at the CDI Conference - Building Resilience in September with my colleague and SAN CDS Jocelyn Cox!
Want to be the next CDS profiled on CDS Snapshot? Contact us at community@cdia.com.au.
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