How can you show your CM efforts’ effectiveness?
Use statistics for administrators, visuals for docs
Your case management department has worked hard to improve the quality of patient care at your hospital while at the same time reducing unnecessary costs and boosting patient satisfaction. You’ve faced numerous obstacles and overcome them, but you and your colleagues never seem to get the credit — or the resources — you deserve. How can you demonstrate your effectiveness to the stakeholders at your facility in a way that will get results?
First, before anyone else can fully appreciate the contributions of your department, you must fully understand the extent of your own strengths and capabilities, says Larry Strassner, a health care consultant with Ernst and Young LLP in Washington, DC.
Strassner says case managers are particularly effective in three areas: financial outcomes, functional outcomes, and provider, patient, and family satisfaction. "Those are the three areas in which case managers either influence or have a direct correlation to improving outcomes," Strassner says. (See chart for a list of ways case managers can influence outcomes, p. 93.)
Once you’ve taken stock of everything you and your colleagues bring to the table, you must identify the stakeholders to whom you must demonstrate your value. "Is it the nurses on the unit, the physicians, or is it the administrator who keeps saying that you need to demonstrate why you need to have a case manager for every 20 patients in the organization?" Strassner says.
Although stakeholders differ at various institutions, most case managers will be forced to demonstrate their value to administrators — both in terms of improving or maintaining the quality of care and being able to reduce the cost of care, Strassner says.
"When you’re working with administration, you’ve got to be able to show them where the savings are," he notes. Strassner recommends starting by presenting a high-level picture of what’s going on in terms of cost containment, and following up by identifying areas of potential improvement. Keep the presentation brief, explaining bottom-line statistics with a minimum of jargon.
In contrast, when you present to physicians, it’s important to demonstrate not just where the savings are but how physicians can assist in the process. "For example, when you begin to benchmark yourself and you look at practice profiles, you might notice that there seems to be a lot of variation around a particular diagnosis, like CHF, in the areas of lab and radiology," Strassner says. While physicians will be interested in dollar figures, they’ll also want to know what they can do differently in those areas. "So physicians are down to the test level," Strassner says. "They ask, What am I doing that’s different from one of my colleagues, who seems to have the lowest cost per case?’"
Strassner says while hard data is important to physicians, it’s just as important to engage physicians in understanding the data by bringing it down to the level of actual practice. "After all, they’re the individuals who have to make the change," he says.
As with administrators, it’s best to start with a presentation of the big picture, using a one- or two-page document. "Physicians tend to prefer a visual display of the data," Strassner says, "so they can quickly look at it and come up with an understanding about what the data are telling them rather than deal with a lot of narrative or a lot of numbers that they have to scroll through. When you’re presenting data to physicians, you need to be right to the point, highlight areas that you want to focus your attention on, and use as many graphics and visual displays as possible."
For more information, contact Larry Strassner, Ernst and Young LLP, 1225 Connecticut Ave. NW, Washington, DC 20036. Telephone: (202) 327-6000.
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