Hospital Case Management – January 1, 2006
January 1, 2006
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Physician advisors can help case managers do their job better
If you arent taking advantage of the assistance your case management physician advisor can offer, or if you dont have an advisor, you may be missing opportunities to move patients safely and efficiently through the continuum of care. -
Physician-case manager team cuts LOS, denials
By working as a team, the physician advisor and case management staff at Mercy Medical Center in Canton, OH, have decreased Medicare length of stay, cut managed care denials dramatically, and made physicians aware of the cost to the hospital of inpatient services that could be done on the outpatient side. -
Don’t rely on Condition Code 44 to fix mistakes
If your hospital is routinely filing claims under Condition Code 44, which changes a patients status from inpatient to outpatient, your system for determining appropriate admissions may be failing. -
Get involved in your insurance contracts
If youre not involved when your hospital contracts with managed care companies, you may miss an opportunity to eliminate denied or avoidable days and maximize reimbursement. -
Critical Path Network: Hospital’s DM program cuts admissions, ED visits
When Jackson Health System in Miami started its first hospital-based disease management program in 1995, the case management department was able to show that the hospital saved $5 for every dollar the hospital spent on case managers in the disease management program. -
Critical Path Network: Lean production efforts help save $7.5M in 1 year
Park Nicollett Health Services (PNHS), a health care system based in St. Louis Park, MN, has demonstrated savings of $7.5 million in 2004 as the result of adopting the Toyota Production System also known as Lean Production. The systems success stories include: -
Critical Path Network: JCAHO to look closely at patient handoffs
An emergency department patient is brought in for an X-ray, but the nurse forgets to tell the radiologist about the patients allergy to contrast dye. During a change of shift, a caregiver doesnt mention that the patient is at high risk for a fall injury. -
Discharge Planning Advisor: System achieves ‘right patient, right level of care’
An increasing number of one-day stays and patients who failed to meet admission criteria formed the impetus for a throughput initiative that is reducing inappropriate admissions at Sutter Health in Sacramento, CA, says Barbara Leach, RN, director of case management for Sacramento Yolo Sutter Health. -
Discharge Planning Advisor: CHF project aims to bridge gap between providers
Drawing on 20 years of quality improvement experience, MPRO, Michigan's Health Care Quality Improvement Organization, is bringing together hospitals, home health agencies, and physician practices to come up with solutions to communications barriers between providers, with the ultimate goal of improving the outcomes for the state's cardiovascular disease patients. -
Patient Safety Alert supplement