What is the role of clinical documentation improvement (CDI)?

The role of clinical documentation improvement (CDI) is primarily focused on enhancing the accuracy of clinical documentation within healthcare settings. Accurate clinical documentation is essential for various reasons, including ensuring proper coding and billing, facilitating effective patient care, and complying with regulatory requirements. When documentation is accurate, it more effectively reflects the treatment and services provided, which in turn enhances patient safety and quality of care.

Furthermore, improved accuracy in clinical documentation can lead to better data for clinical research and quality assessment. This ultimately supports healthcare organizations in achieving better outcomes and optimizing their performance. By prioritizing the improvement of documentation, CDI initiatives directly contribute to the overall effectiveness of healthcare delivery, fostering a more reliable and efficient system.