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 Liz Teiwaki, CDI Team Leader at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. Hear how from an early stage, an interaction with a physician at a resident education session fuelled Liz's passion for CDI.
Tell us about your current role.
I am a CDS currently leading a CDI team at King Faisal Specialist Hospital in Saudi Arabia. The largest and leading tertiary hospital in Saudi Arabia that has been named as a key entity in supporting the Country’s Vision 2030 health care transformation.
What is your career background, and how has that contributed to your ability to work as a CDS?
I have over 15 years of acute care nursing experience ranging from coronary care medical ICU orthopaedic and acute medical. This has helped me immensely transition into the role with the ability to recognise what's going on with the patient's hospital journey to facilitate accurate and complete clinical documentation.
What made you apply for a CDS role?
I have a strong interest in patient safety. Prior to this role I led a project focussing on nursing documentation to improve patient outcomes, and It was then that I was given the role to lead the CDI team. Up to this point I have enjoyed the many challenges and achievements. This role has made me continue to be a patient advocate ensuring that clinical conversations that we often have at the bedside make it to the medical record.
What does your typical day look like?
I usually start the day making sure that the team gets the admission list to organise their reviews for the day. After that it varies from record reviewing to education on the ward and meetings. You get to learn new things in this role and every conversation I have matters whether just getting to know a physician or dietician.
What was the moment when CDI really “clicked” for you?
At the launch of the program the team presented to our new residents. At the end of the presentation the Director of Residency Program got up and said “we document because it is the right thing to do by the patient”. It clicked because this is in line with our hospital values. I needed that support at that moment to remind myself that even though we were just embarking on our CDI journey, there are clinicians out there who welcomed the initiative with understanding. Whenever I talk about CDI to get clinician buy in I repeat that statement.
How would you describe your personal CDI philosophy?
To think the best in people and be resilient. Also knowing your audience is key in delivering the CDI message – (Resident vs Consultant/Chairman). CDI is a journey. It is more than just getting the difficult intubation, nappy rash or anemia documented.
What is the biggest challenge you have faced as a CDS?
The biggest challenge that I have faced as a CDS would be physician engagement and lack of CDI recognition. With this our physicians are keen to learn about coding rather than CDI. The training provided by CDIA has provided great tools to have effective CDI conversations. There are times where it worked and there are times where I just have to back off and process things. Debriefing as a team does help. Another challenge at our hospital is the threat to the program. I have found that our physicians often confused our role with our quality department.
If you could talk to yourself 10 years ago and tell them you’re now a CDS, what do you think they would say?
I would never have thought of doing this role. I would have no idea at all about it. I have landed myself with a career where there are so many challenges and it keeps you going to many avenues.
As a nurse, poor documentation is often frustrating trying to work out what going on with the patient but it was not really until doing the role that I appreciate the impact it has on hospital funding, data integrity and patient safety. It just made sense on how the clinical care that is provided is valued and recognised.
Favourite DRG?
F62 – Heart Failure. Heart failure is one of the most common reasons why patients are hospitalised. I have cared for so many heart failure patient over time and it's only fair now to make sure that I support clinicians to understand the value of documentation to improve patient experience and staff satisfaction.
Favourite additional diagnosis?
I have a couple.
Posthaemorragic anemia – poorly documented . It is quite easy to capture and often documented as a result.
UTI - it is one of the common reasons why our patients stay longer after their surgery. It is quite satisfying when physicians understand the importance of documenting UTI with the organism and the antibiotic resistance to reflect patient complexity to support appropriate length of stay.
What are you excited about in the future of your role?
I am excited about everything in CDI. I believe it will gain recognition in time. Being the first formal CDI program established in Saudi Arabia is very exciting and challenging. I look forward to learning from other local hospitals with the hope to raise the profile of CDI.
Want to be the next CDS profiled on CDS Snapshot? Contact us at community@cdia.com.au.
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