Hospital Case Management – October 1, 2011
October 1, 2011
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To succeed, hospitals improve transitions of care
Healthcare reform mandates, new reimbursement requirements from the Centers for Medicare and Medicaid Services (CMS), and pressure from payers to keep patients out of the hospital and emergency department all mean that hospitals need to do a better job of transitioning patients to another level of care. -
Rule emphasizes quality and cost savings
When the Inpatient Prospective Payment System (IPPS) final rule for 2012 was issued, the Centers for Medicare and Medicaid Services (CMS) stated that its goal is to encourage hospitals to provide higher quality of care at a lower cost and to promote greater efficiencies across all care settings and throughout the entire health system. -
LTACH liaison aids appropriate level of care
At Pennsylvania State University (Penn State) Milton S. Hershey Medical Center in Hershey, PA, a long-term acute care liaison evaluates patients with complex needs for potential placement in a long-term acute care hospital (LTACH), coordinates a comprehensive plan for transition with the treatment team, and works with the accepting facility and the patients' insurers to ensure a smooth transition. -
Coaching helps cut readmissions
A year after Saint Joseph-London Hospital in London, KY, began a heart failure readmissions program, 30-day readmissions dropped from 27.7% to 15.9%. A similar program for patients admitted for acute myocardial infarctions (AMI) reduced the readmissions rate from 23% to 10% in a short time. -
Hospitals, SNFs team up to improve transitions
After Summa Health System and Akron, OH, area nursing facilities formed the Care Coordination Network to improve communication throughout the continuum of care, lengths of stay and readmissions for patients transferred to facilities in the network dropped. -
Education and follow-up cut HF readmissions
A pilot project providing coaching and follow up for heart failure (HF) patients who are readmitted frequently resulted in a 50% drop in the readmission rate at Indiana University (IU) Health Ball Memorial Hospital in Muncie, IN. -
Case Management Insider: The CM leader's role in recruitment and retention
The recruitment and retention of good case managers has never been more important than it is today. In the early years of hospital case management, many case managers transitioned into the role from utilization review or discharge planning positions. -
Case Management Insider: Recruiting methods that stand out in a crowd
Where will we find the new case managers and what will the new candidate look like? They might not be the seasoned clinician as you would hope for. As we need more and more case managers and social workers, some of us might need to look even more broadly for our candidates. -
Case Management Insider: Elements to consider to chose a candidate
Most of the items in in the box "Characteristics and Core Competencies of Potential Candidates" (below) are inherent and/or learned over time. -
Case Management Insider: Job descriptions define perfect candidates
Your job descriptions should clearly define the minimum amount of education that you require for the role of case manager or social worker. -
Case Management Insider: Educating and orienting the new staff
Orientation should be geared to the experiential level of the new staff. The novice case manager will require a different orientation than the experienced case manager. You will need to determine this based on an assessment of the new staff member.