Try some gouda. I hear it’s good. In this age of instantaneous electronic communication, the speed of change is accelerating.

Change brings stress. Not only are we feeling the pressures of a wavering economic situation both here and abroad, we are feeling the encumbrances within the healthcare environment in general and the CDI profession specifically.

Just think about all the ongoing government and payer initiatives underway to improve the quality of healthcare and ensure its ongoing fiscal feasibility.  RAC, MAC, HAC, ICD-10 (maybe ICD-11?), PSI, core measures, POA, meaningful use, Value Based Purchasing, electronic medical records, PEPPER, medical necessity, telecommuting, CC, MCC, SOI, ROM…

Whew!! It is no wonder that nearly every conversation I have includes one of these topics.

As CDI professionals is so easy to stay in the comfort zone; easy to stick to reviewing records simply for that CC/MCC and move on to the next record. Like a favorite old sweater, we envelope ourselves in the familiar and fear new initiatives.

Whenever feel paralyzed from the weight of change around me, I turn to one of my oft-read books Who Moved My Cheese? by Spencer Johnson, MD.

It is a simple, amusing, parable that features four characters; two are mice named Sniff and Scurry, and two are “little people” named Hem and Haw.

The “cheese,” obviously, is the metaphor for what you want to have in life—whether it is a good job, a loving relationship, money, a possession, health, or spiritual peace of mind.

The “Maze” is where you look for what you want—the organization you work in, or the family or community you live in.

Over and over again in the story, the characters face unexpected change. The person running the experiment moves the cheese. Eventually, one character comes to an understanding about the maze and his efforts and writes what he learned on the maze walls. Johnson calls this “the handwriting on the wall,” and when the others come to read it, to see “the handwriting on the wall,” they too, discover how to deal with change, enjoy less stress, and more success.

This is essentially what they learned, the proverbial “writing on the wall:”

  • Change Happens: Someone will always move the cheese
  • Anticipate Change: Understand ahead of time that the cheese will move and be prepared for that eventuality
  • Monitor Change: Keep your nose to the proverbial wind so you can sniff out the new location of the cheese (and so you know when the cheese is getting old
  • Adapt to Change Quickly: The quicker you stop chasing the old cheese, the sooner you can enjoy new cheese
  •  Change: Move with the cheese
  •  Enjoy Change: Savor the adventure and the taste of new cheese!
  •  Be Ready to Quickly Change Again and Again: They keep moving the cheese

I invite you to see “The Handwriting on the Wall,” to face the fear, embrace change and move forward towards success.

“Nothing endures but change.” ~Heraclitus 540 BC – 480 BC


About the Author: Karen Newhouser, RN, BSN, CCM, CCDS, is a CDI consultant with MedPartners HIM. Her background in critical care nursing, case management, plus a certificate as a Medical Coding and Billing Specialist has given her the solid foundation to be successful with CDI since 2004. She finds great reward in sharing her expertise and imparting her knowledge through teaching.