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Faced with a growing number of uninsured patients and rapidly escalating costs for treating them, Brackenridge Hospital in Austin, TX, created a case management program for the uninsured that has resulted in shorter lengths of stays (LOS), fewer readmissions, and less utilization of the emergency department (ED) by patients being managed.
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Higher patient copays and increasing numbers of people who are working but not insured have made the management of self-pay accounts a more crucial issue than ever for most of the nations hospitals.
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In September 1999, INTEGRIS Health asked 10 employees from their two Oklahoma City hospitals, INTEGRIS Southwest Medical Center (ISMC) and INTEGRIS Baptist Medical Center (IBMC), to redesign certain elements of admitting, case management, medical records, and billing practices.
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Communication between hospitals and the primary care providers in the community is essential in managing the care of the uninsured, asserts Diana Resnik, vice president of community care for Seton Healthcare Network in Austin, TX.
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Access managers continue to debate the intricacies of the Emergency Medical Treatment and Labor Act (EMTALA), despite the publication of an EMTALA final rule on Sept. 9, 2003 by the Centers for Medicare & Medicaid Services (CMS). The rule became effective Nov. 10, 2003.
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With nursing units swamped in the afternoon with unscheduled admissions, nurses at the Medical University of South Carolina in Charleston were complaining about the arduous database they had to complete on admission of each patient, notes Maureen McDaniel, RN, manager, bed management, in the patient access services department.
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A process begun four years ago when the Medical University of South Carolina (MUSC) in Charleston took a hard look at pending discharges has led to a cutting-edge bed management program and a best practice designation from two national benchmarking organizations.
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A few years ago, the masters prepared social workers (MSWs) and RN case managers at Hoag Memorial Hospital Presbyterian in Orange County, CA, were having the usual disagreements over who should do what for which patient and who was carrying the heavier load.
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When Haywood Regional Medical Center in Clyde, NC, began tracking case management interventions, staff began by looking at variances in care and documenting them to see how they could improve patient care.
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Control charts, quality tools that can help tighten the focus on process variations, increasingly are gaining acceptance among some health care quality professionals. In fact, a number of Joint Commission on Accreditation of Healthcare Organizations requirements specifically mention the use of control charts.
