Hospital Case Management
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CMS Issues Waivers to Help Case Managers, Hospitals Cope with COVID-19
New York City struggled, as did other hotspots. Patient care units sprung up in public spaces. Busloads of out-of-state nurses, medical residents, and retired doctors, nurses, and therapists pitched in. To expedite patient care, insurance companies waived copays and deductibles. Discharge planning regulations were relaxed. Paperwork took a back seat, as all efforts were directed toward patient care. All this was due to the declaration of a national emergency, which gave impetus to changes from the Centers for Medicare & Medicaid Services.
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Rapid Assessment Zone Re-Engineers Patient Intake Process, Expedites Care
In the continuing quest to minimize wait times and enhance operational efficiency, clinicians and administrators have developed many patient flow models, most of which tend to work best in EDs with specific characteristics or patient populations. Sometimes, a unique model emerges that is worth considering for ED leaders who suspect there is more they could do to optimize their resources and serve patients more efficiently.
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ICU to Long-Term Acute Care: Seamless Transition, Fewer Readmissions
When a seriously ill patient has not stabilized in the ICU, the next step may be a long-term acute care hospital like Spaulding Hospital Cambridge — which often is a difficult transition. Six years ago, Spaulding joined nearby Brigham and Women’s Hospital in creating the Integrated Patient Centered Care in Chronic Critical Illness program to provide a seamless transition of care for these patients and their families.
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Ethics, Case Managers, and the Value Proposition
The pressures case managers face are a reality in a value-based healthcare system. Cost of care and penalties for readmissions are the bottom line in every institution, and that pressure will affect how well case managers perform in their everyday duties. To uphold their ethical tenets, and advocate in the best interests of their patients, a case manager must be prepared to handle these pressures.
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How to Provide Culturally Competent Care
With the increased diversity among today’s hospital patients, case managers must be careful to understand each patient’s culture. People coming from different countries have different expectations of the healthcare system.
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Focusing on Social Determinants of Health Can Reduce ED Revisit Rates
A case management program that focuses on social determinants of health helped a hospital system reduce revisit rates in its ED. The ED’s revisit rate dropped from 6% to 3%.
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COVID-19 Pandemic Changes Nation While Hospitals and Case Managers Cope
The COVID-19 pandemic has disrupted American life and threatens to inundate hospitals with critically ill patients through the spring. Hospitals and case managers can use phone and video conferencing when feasible. Also, they can follow all infectious disease prevention measures.
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The Case Manager’s Toolbox: The Essential Skills of an Effective Case Manager, Part 1
RN case managers and social workers are key advocates in the delivery of quality healthcare. Their broad skills and training allow them to assess patients’ needs and work well with families and other members of the healthcare team. Negotiating, collaborating, communicating, team-building, precepting, educating, and consulting are the basis of what a successful case manager brings to the care setting each day. This month will begin a discussion of the skill sets every case manager and social worker should possess to be as effective in the role as possible.
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Program Tailored to Reducing Senior Patient Readmissions
A program in the Chicago area is demonstrating the value of tailoring discharge plans to the particular needs of elderly patients with little support outside the hospital. These “solo seniors” often face complex medical challenges after discharge and can experience high rates of readmission without help from family and friends. With hospitals facing significant penalties from 30-day readmissions, the program could be a model for hospitals to emulate.
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Case Managers Can Help Patients With Autism Spectrum Disorder
A hospital’s strange sounds, sights, and people can be overwhelming for a child with autism. But a case manager who watches for behavioral cues — and listens carefully to parents — can help that child cope more easily.