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The Centers for Medicare & Medicaid Services (CMS) took additional steps toward value-based purchasing and transparency in health care in the final rule for Medicare payment for outpatient services issued Nov. 1.
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It's not necessary to have a case manager in the emergency department 24 hours a day, seven days a week, and case managers don't necessarily have to screen every patient who comes into the ED, says Toni Cesta, RN, FAAN, vice president, patient flow optimization for the North Shore-Long Island Jewish Health System.
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Through a series of case management initiatives, Methodist Medical Center in Oak Ridge, TN, has dramatically reduced its emergency departments Medicare write-offs and improved its compliance with core measures.
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The ever-increasing demands on case management services require a fresh new look at work practices. One way to do this is through a role redesign project. Role redesign is an improvement technique that involves looking at ways to improve the internal workings of the case management department to better meet the needs of the health care team and patients.
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As a case manager, youre likely to be one of the last people to see patients before they leave the hospital. This gives you the opportunity to make sure they understand their treatment regimen, their follow-up appointment, how to take their medicine, and other components of the discharge plan that can help them recuperate rapidly and avoid readmissions or emergency department visits.
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At Sioux Valley Hospital USD Medical Center in Sioux Falls, SD, case managers often take the lead in developing ways to move patients safely and effectively through the continuum of care.
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Between 2001 and 2005, average length of stay in the emergency department (ED) at Northwestern Memorial Hospital in Chicago had dropped from 85 minutes to 45 minutes. Throughput has fell from 308 minutes to 230 minutes during the same period.
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Just six months after North Mississippi Medical Center began a project to ensure that patients received the recommended medications after a heart attack, the hospitals mortality rate for heart attacks had dropped dramatically, from 15.3% to 8.2%.
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A perception gap often exists today between what health care providers say, prescribe and advise, and what patients actually understand and carry out in their self-care. Many factors can influence this gap, including a lack of language comprehension.