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In the last two issues, we discussed some of the topics related to health care reform that are of greatest interest to case management professionals. This month's Case Management Insider continues this discussion with a look at patient satisfaction, mortality measures, and the new efficiency of care measure.
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Nine hospitals in southern Texas have joined with the area's Agency on the Aging and formed the Rio Grande Valley Readmission Coalition to follow at-risk patients after they are discharged from the hospital in an effort to prevent readmissions.
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By improving processes within the hospital and collaborating with post-acute providers in the community, Charles Cole Memorial Hospital in Coudersport, PA, decreased its 30-day readmission rate for all patients by 15.9% in a one-year period.
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A study conducted at Good Samaritan Hospital in Dayton, OH, has determined that denial rates are lower when case managers collaborate with physicians to determine patients' admission status.
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As part of its efforts to reduce readmissions, WellStar Health System, based in suburban Atlanta, is meeting with post-acute providers to collaborate on ways to make transitions between levels of care smoother. It is piloting a program in which a transition coach works with heart failure patients in the hospital and follows them for four weeks following discharge.
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One of the ways busy EDs are attempting to manage long wait times is by enabling patients who don't need immediate care to make an appointment to be seen in the ED one or two hours in advance.
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When St. Anthony's Hospital and Pinellas Point Nursing and Rehabilitation, both located in St. Petersburg, FL, collaborated on a project to reduce heart failure readmissions, the team determined that many readmissions were for sepsis. They embarked on a project that eliminated sepsis as a reason for readmission in just six months.
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Since the Presbyterian Healthcare Services in Albuquerque, NM, started its emergency department navigation program, targeting patients who seek treatment for minor ailments, 11,600 patients have been navigated to other levels of care. Only about 5% of them have returned to the emergency department with non-emergent conditions or illnesses.
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In this month's issue of Case Management Insider, we will continue our discussion on case management roles, functions, and models, with more information on today's best practice models. We will explore the advantages of each model and minimum staffing ratios for each.
