Hospital Case Management – January 1, 2009
January 1, 2009
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Stop inappropriate admissions to improve your hospital's patient flow
With today's shrinking health care dollars and pressure from payers to move patients through the continuum faster than ever, hospitals need to focus on improving patient flow. That's where case managers come in. -
Compile data to make your case to administration
It will take well-organized data to show your hospital administration how case managers can affect patient flow and to justify additional staff to focus on the effort, says Toni Cesta, RN, PhD, FAAN, vice president, patient flow optimization for the North Shore-Long Island Jewish Health System and health care consultant and partner in Case Management Concepts LLC. -
Innovations help medical center keep LOS low
When patients are admitted to Alamance Regional Medical Center in Burlington, NC, care managers are responsible for assigning the DRG and length of stay and establishing medical necessity and the correct patient status. -
Critical Path Network: CM protocol results in decreased denials
Payer denials for inappropriate observation patient status dropped by 50% the first year after Good Samaritan Hospital in Dayton, OH, instituted a case management protocol that delegates responsibility for determining patient status to case managers. -
Critical Path Network: Education was key to success of CM protocol
Before developing a protocol that delegates authority for determining patient status to case managers, a multidisciplinary team at Good Samaritan Hospital in Dayton, OH, spent several months researching the process, seeking advice from the Florida Quality Improvement Organization (QIO) and hospitals in Florida that had piloted a case management admission status protocol. -
Critical Path Network: Multifaceted approach keeps patients flowing
The emergency department at Middle Tennessee Medical Center (MTMC) in Murfreesboro certainly qualifies as busy: It sees nearly 63,000 patients a year and averages more than 170 patients a day. Yet the average time it takes a patient to get to triage from entry into the ED is 14-17 minutes, and its door-to-doc time averages 35-40 minutes. -
Final OPPS rule links quality of care to payment
In announcing its final rule for the Hospital Outpatient Prospective Payment System (OPPS) for calendar year 2009, the Centers for Medicare & Medicaid Services (CMS) reiterated its intention to strengthen the tie between quality of care furnished to people in hospital outpatient departments and the payments hospitals receive for those services. -
Discharge Planning Quarterly: Pre-admission prediction tool improves process
Sometimes the best response to regulatory and payer changes in health care is to improve the discharge planning process. -
Discharge Planning Quarterly: DP process begins five weeks before surgery
Discharge planning for orthopedic surgery patients at one major hospital begins well in advance of patients being admitted for surgery. -
Family interpreters can cause harm
When hospitals rely on a patient's family members to interpret medical news, they might be placing the patient at risk, an expert says. -
2008 Salary Survey Results: Salaries are up, but case managers have more responsibilities
Case management salaries are on the rise, but the vast majority of case managers are working far more than the typical 40-hour week, according to the 2008 Hospital Case Management salary survey.