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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.
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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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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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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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The role of the social worker in the acute care setting has been evolving for the last two decades.
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A Hartford (CT) Physician Hospital Organization's program to reduce the rate of readmission for patients discharged with a primary diagnosis of heart failure has kept the readmission rate at between 11% and 13% for the last year, according to Linda Conroy, RN, BSN, clinical integration case manager for the Hartford Physician Hospital Organization, a partnership between Hartford Hospital and Hartford Physicians Association.
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Getting an entire staff of physicians, nurses, and techs to do things differently is never easy, but you can clear away hurdles by giving them the ability to formulate some of their own solutions. That, at least, has been the experience of Swedish Medical Center in Issaquah, WA, in its quest to implement a more efficient, no-wait ED concept. The approach appears to be sitting well with patients, too.
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After Good Samaritan Hospital Medical Center in West Islip, NY, began a comprehensive process to reduce readmission rates for heart failure patients, readmission rates dropped from 21.1% to 15.3% in just a few months.
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Every case manager encounters challenging patients and family members those who are angry, provocative, depressed, or just plain ornery. That's because people in the hospital are sick, under stress, and often fearful about their situation.
