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In this first part of a two-part series on benchmarking, we tell about two hospitals that achieved dramatic reductions in length of stay (LOS). Next month, we discuss how to speed up admissions by addressing virtual capacity issues with the entire hospital.
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Descriptions of the following positons: Payer specialists, Placement specialist, Denials management specialist, Staff assistants and Department secretary.
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When it comes to improving quality, sometimes the simplest and least expensive measures work best, reports Earl Kurashige, RN, project manager for Qualis Health, a nonprofit health care quality improvement organization based in Seattle.
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In 1999, Presbyterian Hospital of Dallas had a denial rate of 1.12% of gross revenue at year end. The denial rate began to decline steadily following the implementation of a denials management team and process improvement teams, both of which include members of the case management staff. The process has saved millions of dollars. For fiscal year 2003, the denial rate has dropped to 0.2% of gross revenue.
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Arranging care for uninsured and underinsured patients has become more complicated in the past four or five years, says Jennifer DeCamp, MSW, LSW, a social worker at Swedish Covenant Hospital in Chicago.
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The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has released its 2005 National Patient Safety Goals that will apply specifically to hospitals.
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Seton Northwest Hospital in Austin, TX, launched nearly 50 new quality initiatives in a single four-month period after deciding to participate in the Transforming Care at the Bedside (TCAB) program, which was launched by the Robert Wood Johnson Foundation (RWJF) in Princeton, NJ, and the Boston-based Institute for Healthcare Improvement (IHI).
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Hiring a case manager assigned specifically to manage joint replacement patients has paid dividends for St. Mary Medical Center in Langhorne, PA. The number of total hip and total knee surgeries has increased from 145 in fiscal year 2003 to an expected 260 during this fiscal year.
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An internal case management system for hospital employees who are injured on the job has reduced costs and increased return to work for Allina Hospitals and Clinics, based in Minneapolis.
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