In some ways, it seems that it is nearly impossible to please both the hospital administration and the patients and their families, especially in times of crisis. However, the case manager is in a unique position to bring both along — assuming they have the right tools to do so. Without the help of a wise and invested hospital case manager, the chances of a positive experience for the patient are lower, and hospital spending is more likely to be higher.
An analysis of closed medical malpractice claims related to pain management identifies common areas of risk and reveals the COVID-19 pandemic has created new possibilities for liability. A top contributing factor in 90% of all closed claims was insufficient consent between the physician and the patient or family.
Quality improvement professionals put a great deal of work in improving quality of care and patient safety, with projects both grand in scale and small but significant. But once an organization achieves success, how do leaders make sure the right people know about it?
Whether for financial reasons, to improve integration of care, decrease duplication of clinical services, or to mitigate the financial effect of COVID-19, more hospitals are choosing to consolidate into larger systems. What can hospital case managers do to prepare for this, and how can they handle the transition with grace?
Clinical bioethics training programs serve a wide variety of individuals, some with clinical backgrounds, others with PhDs. Most graduates indicated that their basic training in ethics was adequate. Still, many wanted more training in quality improvement skills, including some exposure to quality improvement methodology. They also wanted to learn how to negotiate for resources and how to communicate with hospital leadership.
Challenged with employing enough staff in case management departments, the need for expertise in every role, and the increased requirements from payers, case management leaders are evaluating centralizing utilization review. This centralization carries both benefits and challenges, some of which are amplified because of the current healthcare climate.