Hip fractures are among the most debilitating and expensive diagnoses to treat, but hospitals can significantly improve outcomes and lower costs if they move hip-fracture patients into surgery quickly, explains Anthony Balsamo, MD, an orthopedic surgeon and head of the Geriatric Fracture Care Program (GFCP) at Geisinger Wyoming Valley Medical Center in Wilkes-Barre, PA.
When case managers for Medical Management International visit clients and providers, they use the latest information technology equipment to enter documentation, create and transmit reports, forward orders for durable medical equipment, tests or procedures, and send letters to patients, physicians, attorneys, or other interested parties, all in real time while they are still with the patients.
Patient education managers must stay abreast of the latest technology for delivering patient education to involve the learner and provide individualizing teaching to meet the needs of the learner, says Fran London, MS, RN, a health education specialist at The Emily Center, Phoenix (AZ) Children's Hospital.
If you don't have a robust clinical documentation improvement program implemented by highly trained staff, your hospital might find itself in trouble in more ways than one.
A few years ago, it was a common practice for case managers to be responsible for clinical documentation improvement along with their other duties, but that should no longer be the case, according to Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and partner and consultant in Dallas-based Case Management Concepts, a case management consulting firm.
As a result of a pre-billing review of charts of patients who die in the hospital, the mortality index at Stony Brook University Medical Center has remained steady at under 1 except for one month when it was 1.04, according to Catherine Morris, RN, MS, CCM, CMAC, executive director of care management and clinical documentation improvement administrator at the 591-bed medical center in Stony Brook, NY.
Case managers are likely to have additional duties added to their workload under a proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) that would require providers to formally notify Medicare beneficiaries of their right to communicate concerns about the quality of the care they received to the state Quality Improvement Organization (QIO).
As reform helps more Americans gain access to health coverage, experts predict that the nation's EDs will be bulging at the seams.
The report card that begins below is an example of a method for aggregating and reporting all the measures that we have reviewed in the last two issues.