Hospital Case Management
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Taking the lead in ensuring that pathways are followed
Case managers are the logical leaders in their hospital’s effort to follow clinical pathways, says Larry Burnett, RN, MS, managing director for Huron Healthcare, a healthcare consulting firm with headquarters in Chicago.
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Developing Pathways is a Team Effort
The first step in creating clinical pathways is to know and understand your data. Identify your opportunities to affect quality and costs.
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They’re Back! Once Out of Favor, Clinical Pathways are Surging
Clinical pathways are being reinvented as changes in reimbursement require hospitals to get a handle on resource consumption and healthcare costs.
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Care coordinators help close gaps in care, lower costs
An initiative that included hiring an RN care coordinator to work with patients who needed a higher level of care, or had gaps in care, resulted in significant improvements in preventive care exams, lower costs for hospitalizations, and a decrease in emergency department visits for patients in the program at Jackson Clinic, a multispecialty practice with 136 providers in western Tennessee. -
Understand, reduce HCW absenteeism
The answer should restore a little of your faith in humanity. For the most part, healthcare workers call in with legitimate illness. -
Embedded CMs reduce readmissions, increase follow-up, cut costs
After Sentara Healthcare System’s embedded case management program was redesigned, the total cost of care for patients in the program dropped by 17% over a three-year period. -
Primary care practices are the latest opportunity for CMs
New opportunities are opening up for case managers in primary care as physician practices, healthcare systems, and health plans recognize the value of care coordination. -
Patient-centered care cuts ED visits, admissions
Horizon Blue Cross Blue Shield of New Jersey members who received care at patient-centered physician practices were able to avoid more than 1,200 emergency department visits and 260 inpatient admissions, which represents a savings of approximately $4.5 million. -
Program connects frequent ED users with medical homes, resources
The ED at Sinai Hospital of Baltimore sees a fair number of patients who frequent the facility for primary care, mental health needs, and other services that emergency providers are not ideally suited to provide. -
Immigrants have social, healthcare challenges
The key to managing the care of a multicultural population is to understand the people with whom you are working and to be aware of the challenges they face, says Sherry Rumbaugh, RN, director of care coordination for Passport Health Plan, a Medicaid health plan with headquarters in Louisville, KY.