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The Agency for Healthcare Research and Quality (AHRQ) has created a website with a wealth of tools to help hospitals set up the Comprehensive Unit-based Safety Program (CUSP). (www.ahrq.gov/cusptoolkit) Frontline users that have implemented CUSP say they not only reduced infections, but dramatically transformed their overall patient safety culture.
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Presbyterian Healthcare Services' Hospital at Home program, which provides acute care services in the homes of patients who might otherwise be hospitalized, has improved patient satisfaction and cut the cost of hospital care by about 30% for the Albuquerque, NM-based integrated healthcare delivery system.
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Case managers have the opportunity to provide valuable assistance to their patients who are frequently readmitted to the hospital with advanced chronic illnesses or who are approaching end of life, says Jennie Roberts, RN, CCM, MBA, chief nursing officer for Evercare Hospice and Palliative Care, based in Minneapolis, which provides hospice and palliative care services throughout the country.
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In today's healthcare environment, as payers tighten reimbursement and auditors from Centers for Medicare & Medicaid Services and commercial payers increase their scrutiny of hospital records, hospitals need to ensure that all patients are admitted in the right level of care and that they move through the continuum as quickly and safely as possible.
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One of the problems associated with the boarding of admitted patients in the ED is that the practice inevitably leads to increased diversion when the ED's capacity to care for new patients is diminished.
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If you haven't expanded your readmission reduction projects beyond heart failure, pneumonia, and acute myocardial infarction, your hospital may find itself with reduced reimbursement in the future, warns 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.
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In the Inpatient Prospective Payment System (IPPS) proposed rule, the Centers for Medicare & Medicaid Services reiterates its intention to shift Medicare reimbursement from a system based on volume to one based on quality of care.
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Instead of thinking of case management as a hospital model, start thinking about case management as a continuum model, which transcends where people receive care, advises 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.
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A care management program that concentrates on high-cost and high-utilizing patients with complex medical and psychosocial needs has reduced the overall readmission rate at the University of Michigan Hospitals and Health Centers to 17.4%, down from 20% when the initiative began.
