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Frustrated patients, core measures that require timely intervention, and optimizing house beds. Those are the issues Bay Medical Center in Panama City, FL, decided it was going to deal when it hired a consultant in 2008.
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Since DCH Regional Medical Center in Tuscaloosa, AL, and the Alabama Quality Assurance Foundation began collaborating on a Medicare demonstration project to determine the most effective ways to reduce readmissions for Medicare patients, the hospital has increased its referrals to home care, nursing homes, community resources, and medication assistance programs.
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Hospitals will be hearing a great deal more about care transitions and reducing readmissions in coming years. Discharge planners and hospitalist leaders will be searching for models that are affordable, effective, and sustainable.
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You may think that because you're a case manager, you don't need to be aware of the implementation of the new International Classification of Diseases (ICD-10) codes. Or you may think that since they don't take effect until Oct. 1, 2013, you don't have to worry about them yet.
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As health care reform rolls out, hospitals will be under more pressure to deliver care faster and more efficiently with better outcomes, coordinating care while patients are still in the hospital, and ensuring a smooth transition to the next level of care. And that's where case managers can make a difference, experts say.
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Hospital case managers are involved with patients from admission through the entire episode of care and discharge, which puts them in a position to spot patient safety issues and work on ways to prevent them, says John Banja, PhD, professor of rehabilitation medicine, medical ethicist at Emory University's Center for Ethics and director of the Section on Ethics in Research at Emory's Atlanta Clinical and Translational Science Institute.
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Recognizing that the transition between the short-term acute care hospital and a long-term acute care hospital (LTAC) is difficult for patients and families, Mesquite Specialty Hospital in Dallas has begun weekly orientation sessions to help family members understand what an LTAC is and how the services a patient will receive there are different from what happens in the short-term acute care hospital.
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Readmissions among all heart failure patients dropped by 50% in the first year of Saddleback Memorial Medical Center's comprehensive heart failure program, which focuses on a smooth transition between the hospital and the community.
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When the ED leadership team at Peninsula Regional Medical Center in Salisbury, MD, set out to improve throughput, the first thing they tackled was the line at the door, says Clark Willis, MD, medical director.
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To reduce legal risks, the best strategy is to "show diligence," says Linda M. Stimmel, JD, a partner with the Dallas-based law firm of Stewart Stimmel.
