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It happens again and again at hospitals across America. A new case manager joins a department and receives minimal on-the-job training from another case manager who is trying to do his or her own job at the same time.
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At New England Baptist Hospital, in Boston, social workers meet most patients at the pre-admission screening appointment. A case manager follows up with at risk patients after discharge to make sure they have a smooth transition home.
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As part of its efforts to increase patient satisfaction and reduce length of stay, City of Hope reorganized its case management department, assigning case managers by unit and assigning all utilization review activities to a dedicated staff of registered nurses.
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[Editor's note: This month we include the first part of a two-part series on demonstrating the value of case management to your organization. We cover metrics to measure and goals for your department. In next month's issue, we'll continue with examples of benchmarking and case management report cards.]
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Examples of financial outcomes measures include length of stay (LOS), cost per day, cost per case, and third party payer denials.
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Quality outcome metrics, compiled for the entire organization, include readmissions, discharge/disposition delays, delays in service/turnaround time, patient satisfaction, and inappropriate admissions.
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Beginning with discharges on Oct. 1, 2012, your hospital's reimbursement could be affected by its performance on quality measures as the Centers for Medicare & Medicaid Services (CMS) implements the value-based purchasing program mandated by the Patient Protection and Affordable Care Act.
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A new regulation from the Centers for Medicare & Medicaid Services (CMS) will have a far-reaching impact on Medicare patients and their providers, including hospital-based case managers, says Jackie Birmingham, RN, BSN, MS, vice president of regulatory monitoring and clinical leadership at Curaspan Health Group.
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Faced with an influx of patients following Hurricane Katrina, North Oaks Health System in Hammond, LA, placed case managers in the emergency department, an initiative that ultimately led to 24-7 coverage by emergency department case managers.
