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At New England Baptist Hospital, in Boston, social workers meet most patients at the pre-admission screening appointment. A case manager follows up with at risk patients after discharge to make sure they have a smooth transition home.
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As part of its efforts to increase patient satisfaction and reduce length of stay, City of Hope reorganized its case management department, assigning case managers by unit and assigning all utilization review activities to a dedicated staff of registered nurses.
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[Editor's note: This month we include the first part of a two-part series on demonstrating the value of case management to your organization. We cover metrics to measure and goals for your department. In next month's issue, we'll continue with examples of benchmarking and case management report cards.]
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Examples of financial outcomes measures include length of stay (LOS), cost per day, cost per case, and third party payer denials.
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Quality outcome metrics, compiled for the entire organization, include readmissions, discharge/disposition delays, delays in service/turnaround time, patient satisfaction, and inappropriate admissions.
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Value-based purchasing has been a much-used term, and the evolution to such a system has been long held as a reality for the future.
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In the first three articles of this series, Vicki Searcy, president, consulting services at Morrisey Associates Inc. in Chicago, introduced the four basic components of clinical privileging. She examined establishing criteria for privileges as well as accepting applications for privileges and applying criteria.
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It's a proposed rule. So it's up for comment. And that's a good thing, because there are many in the field.
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Michelle Buckman, RN, MSN, is a psychiatric clinical nurse specialist working as a consultant to the Loma Linda University Medical Center emergency department.
