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At Medical City Dallas Hospital, there is a healthy competition between two hospitalist groups who compare their outcomes with those of the other group and all the physicians in the hospital, says Beverly Cunningham, MS, RN, director of case management.
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Its a frequent tactic of physicians: claiming that quality data are imperfect, invalid, or otherwise misleading.
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Winning physician buy-in, one of the toughest challenges in any process improvement (PI) endeavor, was the key to success in a PI project undertaken by Peninsula Regional Medical Center in Salisbury, MD.
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When you tackle problems such as avoidable days and denials management, keep the lines of communication open with all departments in your hospital, back up your findings with data, and make sure you provide training to break the cycle, advises Jim Martin, revenue cycle management consultant with VHA Inc., an Irving, TX-based health care cooperative.
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At Delnor Community Hospital in Geneva, IL, case managers work side by side with the clinical staff nurses, an arrangement that has helped earn the hospital the coveted magnet designation from the American Nurses Association in Washington, DC.
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When people are unhappy with case management services, they will tell someone about it. In fact, research shows that people who have a problem are likely to tell eight to 10 other people about it. However, fewer than one in 20 people who have a complaint will protest formally.
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A dramatic overhaul of the emergency department (ED) process at Paradise Valley Hospital in National City, CA, began with a single question from the director of emergency medicine.
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At Good Samaritan Hospital in San Jose, CA, care for stroke patients is coordinated by a registered nurse who follows the patient throughout his or her hospital stay, educates the patient and family members, and coordinates with the hospitals other case managers on discharge needs.
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When health care costs for its employees soared by 60% and out-of-network claims increased by 20% in just a few years, Davis Memorial Hospital in Elkins, WV, took action. The 90-bed community hospital called on the expertise of Tod Thorpe, RN, CPC-H, its former case management director, to manage the health care of its 650 full-time equivalent employees.
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The Breakthrough Series Collaborative model effectively employed by the Institute for Healthcare Improvement (IHI) on a national level has been translated successfully to the regional level in the state of Washington, achieving significant improvement in the self-care efforts of diabetes patients and clinical improvements in areas such as blood sugar and cholesterol.