Hospital Case Management – September 1, 2004

September 1, 2004

• Case managers likely to play big role in pay-for-performance initiatives

  Sometime in the next few years, your hospital could receive some of its Medicare reimbursement based on how well it performs, if the Centers for Medicare & Medicaid Services (CMS) follows its typical course of action.

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• Case managers can lead the way in P4P initiatives

  Case managers will be invaluable to their hospitals if the Centers for Medicare & Medicaid Services (CMS) institutes pay-for-performance measures for all hospitals, Teresa Fugate, RN, BBA, CPHQ, CCM, asserts.

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• Hospitals improve CMS project performance

  An enhanced care management program is the keystone of Bon Secours Health Systems systemwide performance improvement initiatives in connection with the Centers for Medicare & Medicaid Services pay-for-performance demonstration project.

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• Clinical Conditions, Measures for Reporting, and Incentives

  Acute myocardial infarction; Coronary artery bypass graft (CABG); Heart failure; Community-acquired pneumonia; Hip and knee replacement.

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• Telephonic program cuts CHF readmissions in half

  A post-discharge follow-up program for congestive heart failure (CHF) patients has decreased the readmission rate by more than half at Harper University Hospital in Detroit. Nurse case managers specially trained to do triage assessment by telephone follow up with the CHF patients after discharge, making sure patients monitor their weight and blood pressure on a daily basis and reinforcing the patient education instructions patients received during their hospital stay.

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• Critical Path Network: Compliance with protocols may improve outcomes

  What has been called the first large-scale study to examine patient safety issues for isolated coronary artery bypass graft (CABG) showed that hospitals with the highest compliance with three recommended protocols had notably lower risk-adjusted mortality rates than those hospitals whose compliance ranked in the bottom 20%.

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• Critical Path Network: Clinical guidelines for palliative care published

  The National Consensus Project for Quality Palliative Care, a consortium of five palliative care organizations, has released a set of clinical practice guidelines to promote quality palliative care in the United States.

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• Critical Path Network: Do you keep stroke patients waiting too long?

  She may be an ideal candidate for thrombolytic therapy: A woman tells triage nurses that she first noticed symptoms exactly two hours ago. But by the time the patient is appropriately assessed, the window of time for eligibility to be treated with thrombolytics has passed.

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• Ambulatory Care Quarterly: Three strategies to reduce overcrowding and gridlock

  Want to cut your diversion hours down to zero? Thats exactly what Hoag Memorial Hospital Presbyterian in Newport Beach, CA, has done by instituting its emergency saturation triage, or Code EST. When Code EST was implemented in July 2000, diversion hours were about 130 monthly.

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• Ambulatory Care Quarterly: How ED managers can find those elusive beds

  One of the issues constantly plaguing emergency departments (EDs) is the hidden bed a precious commodity when a crunch is on. But there are a number of methods that can help identify those beds sooner, says Marty Karpiel, FACHE, FHFMA, president of Karpiel Consulting Group in Long Beach, CA.

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• Ambulatory Care Quarterly: Reader Question

  Question: How do we avoid patient hoarding, in which nurses or physicians intentionally delay moving a patient out to delay the next patient and give themselves a breather?

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• Protect your hospital’s tax-exempt status

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• Ambulatory Care Quarterly: EDs struggle with growing numbers of uninsured

  In addition to increased numbers of mentally ill patients, emergency departments (EDs) are seeing more uninsured patients than in the past, and the numbers could grow, warns Brian Hancock, MD, president of the American College of Emergency Physicians (ACEP) in Irving, TX. Your budget planning should factor in more uninsured patients, not just the same level you have coped with for years.

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