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An irate customer called the access center at Virtua in Marlton, NJ, complaining that she could not take her child on a maternity tour because of the new visitor restrictions enforced due to the H1N1 outbreak. "She was so upset when she first called that she threatened not to have her new baby at Virtua," says Ninfa Saunders, RN, MSN, MBA, PhD, executive vice president for health services.
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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.
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The nation's first senior emergency center, opened by Holy Cross Hospital in Silver Spring, MD, is specifically tailored to meet the needs of a growing population of adults and provides care that goes beyond the typical emergency department assessment and treatment.
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In the face of steadily increasing volumes (13,000 between 2008 and 2009), the emergency department (ED) at Peninsula Regional Medical Center in Salisbury, MD, has improved all of its operating statistics, achieving a door-to-bed time of three minutes and a door-to-doc time of 21 minutes.
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Recognizing that ED wait times and throughput are affected by the entire hospital, the leaders at King's Daughters Medical Center in Ashland, KY, engaged all the departments that interface with the ED and slashed the rate at which ED patients leave before treatment from 5% to 0.5%.
