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When Cooley Dickinson Hospital (CDH) in Northampton, MA, put the first case manager in its emergency department, some of the staff were skeptical about how well the initiative would work, recalls R.F. Conway, MD, medical director of emergency services and chief of emergency medicine.
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The successful integration of case management and disease management is the latest step in the ongoing evolution of the Sutter Health Sacramento Sierra Region Care Management Programs, says Jan Van der Mei, RN, the region's continuum case management director.
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When Elmhurst Memorial Healthcare looked at improving patient throughput, one of the issues that surfaced had to do with housekeeping, which historically had deployed its work force in a way that did not serve the facility, says Matthew J. Lambert III, MD, MBA, FACS, FACHE, senior vice president, clinical operations.
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A perception gap often exists today between what health care providers say, prescribe and advise, and what patients actually understand and carry out in their self-care. Many factors can influence this gap, including a lack of language comprehension.
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Just six months after North Mississippi Medical Center began a project to ensure that patients received the recommended medications after a heart attack, the hospitals mortality rate for heart attacks had dropped dramatically, from 15.3% to 8.2%.
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Between 2001 and 2005, average length of stay in the emergency department (ED) at Northwestern Memorial Hospital in Chicago had dropped from 85 minutes to 45 minutes. Throughput has fell from 308 minutes to 230 minutes during the same period.
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At Sioux Valley Hospital USD Medical Center in Sioux Falls, SD, case managers often take the lead in developing ways to move patients safely and effectively through the continuum of care.
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As a case manager, youre likely to be one of the last people to see patients before they leave the hospital. This gives you the opportunity to make sure they understand their treatment regimen, their follow-up appointment, how to take their medicine, and other components of the discharge plan that can help them recuperate rapidly and avoid readmissions or emergency department visits.
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The ever-increasing demands on case management services require a fresh new look at work practices. One way to do this is through a role redesign project. Role redesign is an improvement technique that involves looking at ways to improve the internal workings of the case management department to better meet the needs of the health care team and patients.
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Through a series of case management initiatives, Methodist Medical Center in Oak Ridge, TN, has dramatically reduced its emergency departments Medicare write-offs and improved its compliance with core measures.
