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One of the ways busy EDs are attempting to manage long wait times is by enabling patients who don't need immediate care to make an appointment to be seen in the ED one or two hours in advance.
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When St. Anthony's Hospital and Pinellas Point Nursing and Rehabilitation, both located in St. Petersburg, FL, collaborated on a project to reduce heart failure readmissions, the team determined that many readmissions were for sepsis. They embarked on a project that eliminated sepsis as a reason for readmission in just six months.
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Since the Presbyterian Healthcare Services in Albuquerque, NM, started its emergency department navigation program, targeting patients who seek treatment for minor ailments, 11,600 patients have been navigated to other levels of care. Only about 5% of them have returned to the emergency department with non-emergent conditions or illnesses.
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In this month's issue of Case Management Insider, we will continue our discussion on case management roles, functions, and models, with more information on today's best practice models. We will explore the advantages of each model and minimum staffing ratios for each.
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With increasing scrutiny on medical necessity and cuts in reimbursement, along with a growing emphasis on care coordination and transitions in care, case management's position as a major player in the hospital should be assured. But that's not always the case.
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Faced with an increasing number of patients who have no insurance and can't afford to pay for their own care, the University of Iowa Hospitals and Clinics in Iowa City, has developed a multi-pronged approach to identify indigent patients early in their stay and help them get access to community providers who can provide ongoing care.
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In Lee County Florida, providing healthcare for the uninsured and under insured is a community-wide effort, according to Chris Nesheim, RN, MS, CMAC, system director, case management, Lee Memorial Health system with headquarters in Ft. Myers, FL.
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At Montefiore Medical Center in the Bronx, NY, a complex care case manager coordinates appropriate post-discharge options for uninsured and under-insured patients who are likely to need complex care after discharge.
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In order to provide consistent post-acute care for uninsured or under insured patients, hospitals need to think like payers and develop a payment assistance policy so that at admission or registration, a financial counselor can do a quick assessment and determine who qualifies and who doesn't, according to Matt Boettcher, LSW, MSW, vice president for continuum of care for Scott and White Healthcare, with headquarters in Temple, TX, and consultant for the Center for Case Management, a patient care management consulting firm based in Wellesley, MA.
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In its efforts to ensure that the uninsured and homeless receive the healthcare services they need, Carondelet Health Network in Tucson, AZ, has developed a list of community resources and partnered with community agencies to provide care for patients underserved patients.
