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Education is the backbone of home health care, says Eileen McFadden, BSN, MN, manager of educational services at VNA Home Health Care Services in Spokane, WA. It is through education that the patients goals and outcomes are met.
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When a home care patient is from another culture it is a good idea to learn as much as possible about his or her cultural beliefs before the visit, says Jeanne M. Martinez, RN, MPH, CHPN, former quality and education specialist at Northwestern Memorial Home Health Care in Chicago and now a quality specialist with palliative care and home hospice at Northwestern Memorial.
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If you arent taking advantage of the assistance your case management physician advisor can offer, or if you dont have an advisor, you may be missing opportunities to move patients safely and efficiently through the continuum of care.
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By working as a team, the physician advisor and case management staff at Mercy Medical Center in Canton, OH, have decreased Medicare length of stay, cut managed care denials dramatically, and made physicians aware of the cost to the hospital of inpatient services that could be done on the outpatient side.
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If your hospital is routinely filing claims under Condition Code 44, which changes a patients status from inpatient to outpatient, your system for determining appropriate admissions may be failing.
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If youre not involved when your hospital contracts with managed care companies, you may miss an opportunity to eliminate denied or avoidable days and maximize reimbursement.
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Park Nicollett Health Services (PNHS), a health care system based in St. Louis Park, MN, has demonstrated savings of $7.5 million in 2004 as the result of adopting the Toyota Production System also known as Lean Production. The systems success stories include:
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An emergency department patient is brought in for an X-ray, but the nurse forgets to tell the radiologist about the patients allergy to contrast dye. During a change of shift, a caregiver doesnt mention that the patient is at high risk for a fall injury.
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An increasing number of one-day stays and patients who failed to meet admission criteria formed the impetus for a throughput initiative that is reducing inappropriate admissions at Sutter Health in Sacramento, CA, says Barbara Leach, RN, director of case management for Sacramento Yolo Sutter Health.
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When Jackson Health System in Miami started its first hospital-based disease management program in 1995, the case management department was able to show that the hospital saved $5 for every dollar the hospital spent on case managers in the disease management program.
