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Recognizing that hospital readmissions are costly for providers and insurers alike, Blue Cross and Blue Shield of Illinois and the Illinois Hospital Association are collaborating on a quality initiative to reduce the rate of hospital readmissions.
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When it comes to ensuring that patients are receiving high-value, cost-effective care, case managers are where the rubber hits the road, says Michael Taylor, MD, vice president of operations at Executive Health Resources, a Newton Square, PA, healthcare consulting firm.
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After Bassett Medical Center in Cooperstown, NY, began a multidisciplinary program to reduce readmissions, the 30-day readmission rate for high-risk patient diagnoses dropped 70% from 13.4% in 2009 to 0.7% 2010. The initiative earned the medical center a Pinnacle Award for Quality and Patient Safety from the Hospital Association of New York State.
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A pilot program in which parents or caregivers of patients were screened for health literacy reduced healthcare costs and emergency department use for patients at Cook Children's Medical Center in Fort Worth, TX.
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Systems will need to be remediated if they will be used to check medical necessity for ICD-10 standards when they are implemented in October 2013, says Jeffrey Smith, RN, MBA, CPC, a New York City-based manager at Accenture Insight Driven Health, a management and technology consulting company.
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As the clock ticks down toward the implementation of ICD-10, case managers should start learning about the new coding requirements and how they are going to affect what they do on a daily basis.
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As case management leaders, you will be looking for the next generation of case managers to come from the bedside. The following information will review the process you might consider using to facilitate recruitment of staff to your department.
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In October's edition of Case Management Insider, we discussed the importance of using good recruitment and retention strategies in the case management department. Because recruitment is an essential component of retention, this month we will focus on the next generation in case managers: the staff nurses!
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Educators often talk about "teachable moments," those times when the patient is ready to learn. This moment might be in a waiting area, exam room, or a hospital bed. To take advantage of these times, staff members in the Section of Patient Education at Mayo Clinic in Rochester, MN, look for new ways to deliver patient education.
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Disclosing a medical error is never easy, but it can become especially complicated when you need to tell the patient that a previous provider was in the wrong. This delicate situation often requires communication with the other provider before you tell the patient anything.
