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Successful malpractice claims alleging failure to diagnose the post-surgical complication of peritonitis are occurring because patients are sent home without proper evaluation, according to plaintiff attorneys.
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The Centers for Medicare & Medicaid Services Probe and Educate initiative to determine hospitals compliance with the two-midnight rule makes it clear that case managers must review physician documentation as well as medical necessity.
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Case managers have been an integral part of the discharge planning process for decades. Typically this process has involved an in-depth assessment of the patient, which has included their clinical as well as psychosocial, financial and living situations
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When BK Kizziar, RN-BC, CCM, was in the hospital following surgery, a case manager walked into her room the day before discharge and asked whether she wanted to go to an acute rehab facility or have physical therapy sessions at home.
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Bioethicists can advocate for improved communication with family caregivers when a patient is going to be discharged from the hospital.
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When patients benefits have been maxed out or are close to being maxed out, case managers need to be creative with discharge planning, experts say.
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After Southeast Alabama Medical Center in Dothan began a heart failure readmission prevention program, its 30-day readmission rate dropped to an average of 13%. In January, the hospital discharged 62 heart failure patients and only 8% were readmitted.
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At Good Samaritan Medical Center in West Palm Beach, FL, a throughput initiative that uses colored magnets to indicate anticipated discharges has cut emergency department holding time and increased the number of discharges by 2 p.m.
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As outbreaks continue to be reported due to unsafe injection practices and improper use of medication vials, the Centers for Medicare & Medicaid Services (CMS) is telling its surveyors to contact public health departments immediately if they see such flagrant breaches of infection control.
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Case managers should know their patients insurance benefits and out-of-pocket expenses when they develop a discharge plan to make sure the patient can afford the plan they are putting in place.
