Hospital Case Management – September 1, 2023

Case Managers Could Use Z Codes More for Patient Care and QI

Case managers, providers, and health systems underuse ICD-10 Z codes eight years after they were introduced. These codes could provide a wealth of data to researchers and case management quality improvement projects. They still hold promise to be a way for providers to collect reimbursement for their work to help patients with their social determinants of health.

Screening and Documenting Cases of Human Trafficking Are Important, But Carry Risks

Human trafficking is a critical issue from a public health perspective. It has lasting psychological and physical effects on victims. There is too little information about how prevalent human trafficking is in the United States and how often the victims are seen in healthcare settings. Case managers, hospitals, and ambulatory providers could improve the data by documenting suspected or confirmed human trafficking cases via Z codes.

How Case Managers Can Help Victims of Trafficking

Case managers can learn skills and tactics for helping patients who have been trafficked. For example, investigators used an online training module to educate ED staff about human trafficking. Participants reported more confidence in identifying a possible human trafficking victim, noting they were more likely to screen patients for human trafficking.

Stroke Patient Navigator Prevents 30-Day Readmissions

A stroke nurse navigator team can prevent 30-day readmissions in stroke patients treated with thrombolysis, investigators found. A health system’s 30-day readmission rate was 13.6% before it began to use a stroke nurse navigator. The rate declined to 6.9%. Patients with the stroke nurse implementation were 67.6% less likely to be readmitted within 30 days compared to patients without the navigator.

International Discharges Create Chaos and Inspire Creativity for Case Managers

Case managers and discharge planners in every state sometimes encounter the most challenging and frustrating of cases: the international discharge. Hospital Case Management asked Judith R. Sands, RN, MSL, BSN, CPHRM, CPHQ, CCM, ARM, a clinical consultant and author of Home Hospice Navigation: The Caregiver’s Guide, to answer a few questions about best practices in handling these unique care transition cases.

Care Coordination and Communication Needed Between Transplant Providers and Primary Care

Cirrhosis affects a small percentage of the U.S. population. But it is a highly complex disease that leads to high hospital readmission rates and a higher cost per patient than found in heart failure and COPD. Investigators found care coordination and efficient communication between providers can optimize care. Telehealth can help patients, particularly for return visits.

Case Management Challenges in the Emergency Department

Hospital case management already is unique. But carrying out this role in the ED brings even more challenge and intensity to bear. It also affects operations and well-being in the rest of the hospital.

For Clinicians, Discharge Safety Is a Growing Ethical Concern

More often, clinicians are asking ethicists questions such as, “Is this discharge plan ethical?” It seems clinicians are distressed over what they consider to be unsafe decisions. Clinicians create a treatment plan based on what they believe is in the patient’s best interest. For various reasons, sometimes the plan is just not feasible.