{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:27:30Z","timestamp":1782484050269,"version":"3.54.5"},"reference-count":46,"publisher":"American Health Information Management Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Adv Health Inf Sci Pract"],"published-print":{"date-parts":[[2025,11,19]]},"abstract":"\n Background<\/jats:title>\n Clinical Documentation Integrity (CDI) programs aid in documentation of precise diagnoses. In this study, the authors assessed the rate at which certain diagnoses were present in the Pediatric Health Information System (PHIS) database and evaluated changes in the hospital-specific case mix index (CMI) pre- and post-CDI program inception at six children\u2019s hospitals.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between 2011 and 2017, CDI programs were implemented at six children\u2019s hospitals. The authors queried the PHIS database to compare the following diagnoses in 2010 and 2021: acute respiratory failure, chronic respiratory failure, ventilator dependence, dysphagia, malnutrition, and presence of a gastrostomy and\/or jejunostomy (G\/J) tube in patients with aspiration.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n From 2010 to 2021, CMI increased at all hospitals. For all hospitals\u2019 inpatient encounters, the percentage of patients with acute respiratory failure and malnutrition increased (both\n p<\/jats:italic>\n <0.001). Documentation of chronic respiratory failure increased (\n p<\/jats:italic>\n < 0.001) and ventilator dependence decreased (\n p<\/jats:italic>\n < 0.001) at all institutions. There were variations at the hospital level for capture of dysphagia, G\/J and both diagnoses together.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n CMI increased and the rate of specific diagnoses in the PHIS database increased from 2010 to 2021, which corresponded to implementation of all institutions\u2019 CDI programs. Documentation of specific, clinically-relevant diagnoses in the medical record ensures optimal healthcare provider communication, proper severity of illness representation, appropriate hospital reimbursement, accurate quality metric reporting and database accuracy.<\/jats:p>\n <\/jats:sec>","DOI":"10.63116\/cgja8827","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T15:54:52Z","timestamp":1763567692000},"source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Clinical Documentation Integrity Programs on Diagnosis Documentation"],"prefix":"10.63116","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3886-0666","authenticated-orcid":true,"given":"Amy L.","family":"Sanderson","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital https:\/\/dx.doi.org\/https:\/\/ror.org\/00dvg7y05"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucinda","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children\u2019s Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Arafiles","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Phoenix Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ara","family":"Balkian","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Children\u2019s Hospital Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daxa P.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Phoenix Children\u2019s Hospital https:\/\/dx.doi.org\/https:\/\/ror.org\/03ae6qy41"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Dees","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hospital Medicine Johns Hopkins All Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna M.","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Patient Care Operations Boston Children\u2019s Hospital https:\/\/dx.doi.org\/https:\/\/ror.org\/00dvg7y05"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Melvin","sequence":"additional","affiliation":[{"name":"Center for Applied Pediatric Quality Analytics Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Staffa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital https:\/\/dx.doi.org\/https:\/\/ror.org\/00dvg7y05"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zurakowski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Boston Children\u2019s Hospital"},{"name":"Department of Surgery Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheilah","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children\u2019s Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"52461","reference":[{"issue":"12","key":"ref-500441","series-title":"Clin J Am Soc Nephrol","first-page":"2036","article-title":"Recognition and reporting of AKI in very low birth weight infants","volume":"9","author":"Carmody","year":"2014","unstructured":"Carmody\n J. B.\n \n \n Swanson\n J. R.\n \n \n Rhone\n E. T.\n \n \n Charlton\n J. R.\n \n Recognition and reporting of AKI in very low birth weight infants. Clin J Am Soc Nephrol. 2014;9(12):2036-43\n https:\/\/doi.org\/10.2215\/CJN.05190514"},{"issue":"1","key":"ref-500442","series-title":"J Eval Clin Pract","first-page":"36","article-title":"Level of accuracy of diagnoses recorded in discharge summaries: A cohort study in three respiratory wards","volume":"25","author":"Tsopra","year":"2019","unstructured":"Tsopra\n R.\n \n \n Wyatt\n J.C.\n \n \n Beirne\n P.\n \n \n Level of accuracy of diagnoses recorded in discharge summaries: A cohort study in three respiratory wards J Eval Clin Pract. 2019;25(1):36-43. https:\/\/doi.org\/10.1111\/jep.13020"},{"key":"ref-500443","series-title":"Int J Pediatr","first-page":"4068582","article-title":"Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers","volume":"2016","author":"Brady","year":"2016","unstructured":"Brady\n C. C.\n \n \n Thaker\n V. V.\n \n \n Lingren\n T.\n \n \n Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers. Int J Pediatr. 2016;2016:4068582\nhttps:\/\/doi.org\/10.1155\/2016\/4068582"},{"key":"ref-500444","series-title":"Pediatr Crit Care Med","article-title":"Diagnosis Documentation of Critically Ill Children on Admission to a Pediatric Intensive Care Unit","author":"Vivtcharenko","year":"2021","unstructured":"Vivtcharenko\n V. Y.\n \n \n Ramesh\n S.\n \n \n Dukes\n K. C.\n \n \n Diagnosis Documentation of Critically Ill Children on Admission to a Pediatric Intensive Care Unit. Pediatr Crit Care Med. Published online 2021.\n https:\/\/doi.org\/10.1097\/PCC.0000000000002812\n 34534163"},{"key":"ref-500445","series-title":"3M APR DRG classification system version 26.1. Methodology overview","author":"Averill","unstructured":"Averill\n R. F.\n \n \n Goldfield\n N.\n \n \n Hughes\n J.\n \n \n 3M APR DRG classification system version 26.1. Methodology overview. Accessed August 24, 2024.\n http:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nis\/v261_aprdrg_meth_ovrview.pdf"},{"issue":"7","key":"ref-500446","series-title":"Hosp Pediatr","first-page":"430","article-title":"An Educational Intervention to Improve Inpatient Documentation of High-risk Diagnoses by Pediatric Residents","volume":"8","author":"Kulkarni","year":"2018","unstructured":"Kulkarni\n D.\n \n \n Heath\n J.\n \n \n Kosack\n A.\n \n \n Jackson\n N. J.\n \n \n Crummey\n A.\n \n An Educational Intervention to Improve Inpatient Documentation of High-risk Diagnoses by Pediatric Residents. Hosp Pediatr. 2018;8(7):430-435\n https:\/\/doi.org\/10.1542\/hpeds.2017-0163"},{"issue":"1071","key":"ref-500447","series-title":"Postgrad Med J","first-page":"22","article-title":"Improving the quality of documentation of paediatric post-take ward rounds: the impact of an acrostic","volume":"91","author":"Newnham","year":"2015","unstructured":"Newnham\n A. L.\n \n \n Hine\n C.\n \n \n Rogers\n C.\n \n \n Agwu\n J. C.\n \n Improving the quality of documentation of paediatric post-take ward rounds: the impact of an acrostic Postgrad Med J. 2015;91(1071):22-25.\n \n https:\/\/doi.org\/10.1136\/postgradmedj-2013-132534"},{"issue":"8","key":"ref-500448","series-title":"Am J Med","first-page":"739","article-title":"Capturing the diagnosis: an internal medicine education program to improve documentation","volume":"126","author":"Spellberg","year":"2013","unstructured":"Spellberg\n B.\n \n \n Harrington\n D.\n \n \n Black\n S.\n \n \n Sue\n D.\n \n \n Stringer\n W.\n \n \n Witt\n M.\n \n Capturing the diagnosis: an internal medicine education program to improve documentation Am J Med. 2013;126(8):739-743e1. https:\/\/doi.org\/10.1016\/j.amjmed.2012.11.035"},{"issue":"1","key":"ref-500449","series-title":"Otolaryngol Head Neck Surg","first-page":"143","article-title":"Improved Comorbidity Capture Using a Standardized 1-Step Quality Improvement Documentation Tool","volume":"159","author":"Morrison","year":"2018","unstructured":"Morrison\n R. J.\n \n \n Malloy\n K. M.\n \n \n Bakshi\n R. R.\n \n Improved Comorbidity Capture Using a Standardized 1-Step Quality Improvement Documentation Tool. Otolaryngol Head Neck Surg. 2018;159(1):143-148. https:\/\/doi.org\/10.1177\/0194599818764669"},{"issue":"3","key":"ref-500450","series-title":"J Am Coll Surg","first-page":"301","article-title":"Implementation of a Clinical Documentation Improvement Curriculum Improves Quality Metrics and Hospital Charges in an Academic Surgery Department","volume":"224","author":"Reyes","year":"2017","unstructured":"Reyes\n C.\n \n \n Greenbaum\n A.\n \n \n Porto\n C.\n \n \n Russell\n J.C.\n \n Implementation of a Clinical Documentation Improvement Curriculum Improves Quality Metrics and Hospital Charges in an Academic Surgery Department J Am Coll Surg. 2017;224(3):301-309. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2016.11.010"},{"issue":"3","key":"ref-500451","series-title":"Hosp Pediatr","first-page":"298","article-title":"Impact of a Clinical Documentation Integrity Program on Severity of Illness of Expired Patients","volume":"11","author":"Reardon","year":"2021","unstructured":"Reardon\n K. E.\n \n \n Foley\n C. M.\n \n \n Melvin\n P.\n \n \n Agus\n M. S. D.\n \n \n Sanderson\n A. L.\n \n Impact of a Clinical Documentation Integrity Program on Severity of Illness of Expired Patients. Hosp Pediatr. 2021;11(3):298-302. https:\/\/doi.org\/10.1542\/hpeds.2020-000851"},{"issue":"2","key":"ref-500452","series-title":"J Vasc Surg","first-page":"599","article-title":"Impact of a care delivery redesign initiative for vascular surgery","volume":"71","author":"Peralta","year":"2020","unstructured":"Peralta\n J.\n \n \n Ham\n S.W.\n \n \n Magee\n G.A.\n \n \n Impact of a care delivery redesign initiative for vascular surgery J Vasc Surg. 2020;71(2):599-608e1. https:\/\/doi.org\/10.1016\/j.jvs.2019.03.053"},{"key":"ref-500453","series-title":"Pediatric Respiratory Failure: The Need for Specific Definitions","author":"Bica","year":"2016","unstructured":"Bica\n V.\n \n \n Bridgeman\n K.\n \n \n Buyrn\n M.\n \n \n Pediatric Respiratory Failure: The Need for Specific Definitions.\n 2016. Accessed June 1, 2024.\n https:\/\/acdis.org\/resources\/pediatric-respiratory-failure-need-specific-definitions"},{"issue":"1","key":"ref-500454","series-title":"Pediatr Rev","first-page":"e1","article-title":"Failure to thrive: a consequence of undernutrition","volume":"27","author":"Gahagan","year":"2006","unstructured":"Gahagan\n S.\n \n Failure to thrive: a consequence of undernutrition Pediatr Rev. 2006;27(1):e1-11. https:\/\/doi.org\/10.1542\/pir.27-1-e1"},{"key":"ref-500455","series-title":"Malnutrition","author":"Organization WH","unstructured":"Organization WH\n . Malnutrition. Accessed June 15, 2024.\n https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/malnutrition"},{"issue":"4","key":"ref-500456","series-title":"JPEN J Parenter Enteral Nutr","first-page":"460","article-title":"Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions","volume":"37","author":"Mehta","year":"2013","unstructured":"Mehta\n N. M.\n \n \n Corkins\n M. R.\n \n \n Lyman\n B.\n \n \n Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions JPEN J Parenter Enteral Nutr.\n 2013;37(4):460-81. https:\/\/doi.org\/10.1177\/0148607113479972"},{"key":"ref-500457","unstructured":"PHIS. Children\u2019s Hospital Association.\n 2024-7-7\n https:\/\/www.childrenshospitals.org\/phis"},{"key":"ref-500458","series-title":"Int J Surg","first-page":"288","article-title":"Improved clinical documentation leads to superior reportable outcomes: An accurate representation of patient's clinical status","volume":"53","author":"Elkbuli","year":"2018","unstructured":"Elkbuli\n A.\n \n \n Godelman\n S.\n \n \n Miller\n A.\n \n \n Improved clinical documentation leads to superior reportable outcomes: An accurate representation of patient's clinical status Int J Surg.\n 2018;53:288-291. https:\/\/doi.org\/10.1016\/j.ijsu.2018.03.081"},{"issue":"1","key":"ref-500459","series-title":"BMC Med Res Methodol","first-page":"89","article-title":"Limitations of pulmonary embolism ICD-10 codes in emergency department administrative data: let the buyer beware","volume":"17","author":"Burles","year":"2017","unstructured":"Burles\n K.\n \n \n Innes\n G.\n \n \n Senior\n K.\n \n \n Lang\n E.\n \n \n McRae\n A.\n \n Limitations of pulmonary embolism ICD-10 codes in emergency department administrative data: let the buyer beware. BMC Med Res Methodol.\n 2017;17(1):89\nhttps:\/\/doi.org\/10.1186\/s12874-017-0361-1"},{"key":"ref-500460","series-title":"BMC Health Serv Res","first-page":"99","article-title":"Do coder characteristics influence validity of ICD-10 hospital discharge data?","volume":"10","author":"Hennessy","year":"2010","unstructured":"Hennessy\n D. A.\n \n \n Quan\n H.\n \n \n Faris\n P. D.\n \n \n Beck\n C. A.\n \n Do coder characteristics influence validity of ICD-10 hospital discharge data?. BMC Health Serv Res.\n\n 2010;10:99\nhttps:\/\/doi.org\/10.1186\/1472-6963-10-99"},{"issue":"2","key":"ref-500461","series-title":"Health Informatics J","first-page":"101","article-title":"Chart documentation quality and its relationship to the validity of administrative data discharge records","volume":"16","author":"So","year":"2010","unstructured":"So\n L.\n \n \n Beck\n C. A.\n \n \n Brien\n S.\n \n \n Chart documentation quality and its relationship to the validity of administrative data discharge records Health Informatics J.\n 2010;16(2):101-113. https:\/\/doi.org\/10.1177\/1460458210364784"},{"issue":"1","key":"ref-500462","series-title":"Health Inf Manag","first-page":"35","article-title":"The risk and consequences of clinical miscoding due to inadequate medical documentation: a case study of the impact on health services funding","volume":"38","author":"Cheng","year":"2009","unstructured":"Cheng\n P.\n \n \n Gilchrist\n A.\n \n \n Robinson\n K. M.\n \n \n Paul\n L.\n \n The risk and consequences of clinical miscoding due to inadequate medical documentation: a case study of the impact on health services funding. Health Inf Manag. 2009;38(1):35-46. https:\/\/doi.org\/10.1177\/183335830903800105"},{"issue":"10","key":"ref-500463","series-title":"JAMA Netw Open","first-page":"e2129920","article-title":"Trends in Hospital Costs and Levels of Services Provided for Children With Bronchiolitis Treated in Children's Hospitals","volume":"4","author":"Willer","year":"2021","unstructured":"Willer\n R. J.\n \n \n Coon\n E. R.\n \n \n Harrison\n W. N.\n \n \n Ralston\n S. L.\n \n Trends in Hospital Costs and Levels of Services Provided for Children With Bronchiolitis Treated in Children's Hospitals. JAMA Netw Open.\n\n2021;4(10):e2129920\nhttps:\/\/doi.org\/10.1001\/jamanetworkopen.2021.29920"},{"issue":"12","key":"ref-500441","series-title":"Clin J Am Soc Nephrol","first-page":"2036","article-title":"Recognition and reporting of AKI in very low birth weight infants","volume":"9","author":"Carmody","year":"2014","unstructured":"Carmody\n J. B.\n \n \n Swanson\n J. R.\n \n \n Rhone\n E. T.\n \n \n Charlton\n J. R.\n \n Recognition and reporting of AKI in very low birth weight infants. Clin J Am Soc Nephrol. 2014;9(12):2036-43\n https:\/\/doi.org\/10.2215\/CJN.05190514"},{"issue":"1","key":"ref-500442","series-title":"J Eval Clin Pract","first-page":"36","article-title":"Level of accuracy of diagnoses recorded in discharge summaries: A cohort study in three respiratory wards","volume":"25","author":"Tsopra","year":"2019","unstructured":"Tsopra\n R.\n \n \n Wyatt\n J.C.\n \n \n Beirne\n P.\n \n \n Level of accuracy of diagnoses recorded in discharge summaries: A cohort study in three respiratory wards J Eval Clin Pract. 2019;25(1):36-43. https:\/\/doi.org\/10.1111\/jep.13020"},{"key":"ref-500443","series-title":"Int J Pediatr","first-page":"4068582","article-title":"Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers","volume":"2016","author":"Brady","year":"2016","unstructured":"Brady\n C. C.\n \n \n Thaker\n V. V.\n \n \n Lingren\n T.\n \n \n Suboptimal Clinical Documentation in Young Children with Severe Obesity at Tertiary Care Centers. Int J Pediatr. 2016;2016:4068582\nhttps:\/\/doi.org\/10.1155\/2016\/4068582"},{"key":"ref-500444","series-title":"Pediatr Crit Care Med","article-title":"Diagnosis Documentation of Critically Ill Children on Admission to a Pediatric Intensive Care Unit","author":"Vivtcharenko","year":"2021","unstructured":"Vivtcharenko\n V. Y.\n \n \n Ramesh\n S.\n \n \n Dukes\n K. C.\n \n \n Diagnosis Documentation of Critically Ill Children on Admission to a Pediatric Intensive Care Unit. Pediatr Crit Care Med. Published online 2021.\n https:\/\/doi.org\/10.1097\/PCC.0000000000002812\n 34534163"},{"key":"ref-500445","series-title":"3M APR DRG classification system version 26.1. Methodology overview","author":"Averill","unstructured":"Averill\n R. F.\n \n \n Goldfield\n N.\n \n \n Hughes\n J.\n \n \n 3M APR DRG classification system version 26.1. Methodology overview. Accessed August 24, 2024.\n http:\/\/www.hcup-us.ahrq.gov\/db\/nation\/nis\/v261_aprdrg_meth_ovrview.pdf"},{"issue":"7","key":"ref-500446","series-title":"Hosp Pediatr","first-page":"430","article-title":"An Educational Intervention to Improve Inpatient Documentation of High-risk Diagnoses by Pediatric Residents","volume":"8","author":"Kulkarni","year":"2018","unstructured":"Kulkarni\n D.\n \n \n Heath\n J.\n \n \n Kosack\n A.\n \n \n Jackson\n N. J.\n \n \n Crummey\n A.\n \n An Educational Intervention to Improve Inpatient Documentation of High-risk Diagnoses by Pediatric Residents. Hosp Pediatr. 2018;8(7):430-435\n https:\/\/doi.org\/10.1542\/hpeds.2017-0163"},{"issue":"1071","key":"ref-500447","series-title":"Postgrad Med J","first-page":"22","article-title":"Improving the quality of documentation of paediatric post-take ward rounds: the impact of an acrostic","volume":"91","author":"Newnham","year":"2015","unstructured":"Newnham\n A. L.\n \n \n Hine\n C.\n \n \n Rogers\n C.\n \n \n Agwu\n J. C.\n \n Improving the quality of documentation of paediatric post-take ward rounds: the impact of an acrostic Postgrad Med J. 2015;91(1071):22-25.\n \n https:\/\/doi.org\/10.1136\/postgradmedj-2013-132534"},{"issue":"8","key":"ref-500448","series-title":"Am J Med","first-page":"739","article-title":"Capturing the diagnosis: an internal medicine education program to improve documentation","volume":"126","author":"Spellberg","year":"2013","unstructured":"Spellberg\n B.\n \n \n Harrington\n D.\n \n \n Black\n S.\n \n \n Sue\n D.\n \n \n Stringer\n W.\n \n \n Witt\n M.\n \n Capturing the diagnosis: an internal medicine education program to improve documentation Am J Med. 2013;126(8):739-743e1. https:\/\/doi.org\/10.1016\/j.amjmed.2012.11.035"},{"issue":"1","key":"ref-500449","series-title":"Otolaryngol Head Neck Surg","first-page":"143","article-title":"Improved Comorbidity Capture Using a Standardized 1-Step Quality Improvement Documentation Tool","volume":"159","author":"Morrison","year":"2018","unstructured":"Morrison\n R. J.\n \n \n Malloy\n K. M.\n \n \n Bakshi\n R. R.\n \n Improved Comorbidity Capture Using a Standardized 1-Step Quality Improvement Documentation Tool. Otolaryngol Head Neck Surg. 2018;159(1):143-148. https:\/\/doi.org\/10.1177\/0194599818764669"},{"issue":"3","key":"ref-500450","series-title":"J Am Coll Surg","first-page":"301","article-title":"Implementation of a Clinical Documentation Improvement Curriculum Improves Quality Metrics and Hospital Charges in an Academic Surgery Department","volume":"224","author":"Reyes","year":"2017","unstructured":"Reyes\n C.\n \n \n Greenbaum\n A.\n \n \n Porto\n C.\n \n \n Russell\n J.C.\n \n Implementation of a Clinical Documentation Improvement Curriculum Improves Quality Metrics and Hospital Charges in an Academic Surgery Department J Am Coll Surg. 2017;224(3):301-309. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2016.11.010"},{"issue":"3","key":"ref-500451","series-title":"Hosp Pediatr","first-page":"298","article-title":"Impact of a Clinical Documentation Integrity Program on Severity of Illness of Expired Patients","volume":"11","author":"Reardon","year":"2021","unstructured":"Reardon\n K. E.\n \n \n Foley\n C. M.\n \n \n Melvin\n P.\n \n \n Agus\n M. S. D.\n \n \n Sanderson\n A. L.\n \n Impact of a Clinical Documentation Integrity Program on Severity of Illness of Expired Patients. Hosp Pediatr. 2021;11(3):298-302. https:\/\/doi.org\/10.1542\/hpeds.2020-000851"},{"issue":"2","key":"ref-500452","series-title":"J Vasc Surg","first-page":"599","article-title":"Impact of a care delivery redesign initiative for vascular surgery","volume":"71","author":"Peralta","year":"2020","unstructured":"Peralta\n J.\n \n \n Ham\n S.W.\n \n \n Magee\n G.A.\n \n \n Impact of a care delivery redesign initiative for vascular surgery J Vasc Surg. 2020;71(2):599-608e1. https:\/\/doi.org\/10.1016\/j.jvs.2019.03.053"},{"key":"ref-500453","series-title":"Pediatric Respiratory Failure: The Need for Specific Definitions","author":"Bica","year":"2016","unstructured":"Bica\n V.\n \n \n Bridgeman\n K.\n \n \n Buyrn\n M.\n \n \n Pediatric Respiratory Failure: The Need for Specific Definitions.\n 2016. Accessed June 1, 2024.\n https:\/\/acdis.org\/resources\/pediatric-respiratory-failure-need-specific-definitions"},{"issue":"1","key":"ref-500454","series-title":"Pediatr Rev","first-page":"e1","article-title":"Failure to thrive: a consequence of undernutrition","volume":"27","author":"Gahagan","year":"2006","unstructured":"Gahagan\n S.\n \n Failure to thrive: a consequence of undernutrition Pediatr Rev. 2006;27(1):e1-11. https:\/\/doi.org\/10.1542\/pir.27-1-e1"},{"key":"ref-500455","series-title":"Malnutrition","author":"Organization WH","unstructured":"Organization WH\n . Malnutrition. Accessed June 15, 2024.\n https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/malnutrition"},{"issue":"4","key":"ref-500456","series-title":"JPEN J Parenter Enteral Nutr","first-page":"460","article-title":"Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions","volume":"37","author":"Mehta","year":"2013","unstructured":"Mehta\n N. M.\n \n \n Corkins\n M. R.\n \n \n Lyman\n B.\n \n \n Defining pediatric malnutrition: a paradigm shift toward etiology-related definitions JPEN J Parenter Enteral Nutr.\n 2013;37(4):460-81. https:\/\/doi.org\/10.1177\/0148607113479972"},{"key":"ref-500457","unstructured":"PHIS. Children\u2019s Hospital Association.\n 2024-7-7\n https:\/\/www.childrenshospitals.org\/phis"},{"key":"ref-500458","series-title":"Int J Surg","first-page":"288","article-title":"Improved clinical documentation leads to superior reportable outcomes: An accurate representation of patient's clinical status","volume":"53","author":"Elkbuli","year":"2018","unstructured":"Elkbuli\n A.\n \n \n Godelman\n S.\n \n \n Miller\n A.\n \n \n Improved clinical documentation leads to superior reportable outcomes: An accurate representation of patient's clinical status Int J Surg.\n 2018;53:288-291. https:\/\/doi.org\/10.1016\/j.ijsu.2018.03.081"},{"issue":"1","key":"ref-500459","series-title":"BMC Med Res Methodol","first-page":"89","article-title":"Limitations of pulmonary embolism ICD-10 codes in emergency department administrative data: let the buyer beware","volume":"17","author":"Burles","year":"2017","unstructured":"Burles\n K.\n \n \n Innes\n G.\n \n \n Senior\n K.\n \n \n Lang\n E.\n \n \n McRae\n A.\n \n Limitations of pulmonary embolism ICD-10 codes in emergency department administrative data: let the buyer beware. BMC Med Res Methodol.\n 2017;17(1):89\nhttps:\/\/doi.org\/10.1186\/s12874-017-0361-1"},{"key":"ref-500460","series-title":"BMC Health Serv Res","first-page":"99","article-title":"Do coder characteristics influence validity of ICD-10 hospital discharge data?","volume":"10","author":"Hennessy","year":"2010","unstructured":"Hennessy\n D. A.\n \n \n Quan\n H.\n \n \n Faris\n P. D.\n \n \n Beck\n C. A.\n \n Do coder characteristics influence validity of ICD-10 hospital discharge data?. BMC Health Serv Res.\n\n 2010;10:99\nhttps:\/\/doi.org\/10.1186\/1472-6963-10-99"},{"issue":"2","key":"ref-500461","series-title":"Health Informatics J","first-page":"101","article-title":"Chart documentation quality and its relationship to the validity of administrative data discharge records","volume":"16","author":"So","year":"2010","unstructured":"So\n L.\n \n \n Beck\n C. 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