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One effective way for hospitals to improve patient care and reduce rehospitalizations and longer lengths of stay (LOS) is to take a Lean approach. Lean and Lean Six Sigma principles can help a healthcare organization eliminate waste and improve quality, and outcomes. For example, after employing Lean principles, Mid Coast-Parkview Health in Brunswick, ME, shortened patient stays of 30 or more days by more than 20%, saving $124,000.
Long length-of-stay patients can cost hospitals hundreds of thousands of dollars in unreimbursed care each year. Hospital case managers can help reduce these cases through consistent care management and team support.
Too often, patient information is lost or inadequate during transitions from hospital to skilled nursing facilities. This causes challenges that case managers can help overcome.
When hospitalized patients need to be transitioned to a skilled nursing facility, one of the first hurdles is finding the right place. Spaulding Rehabilitation Hospital in Boston has developed a one-page tool to help families with this decision.
New rules intended to help empower patients preparing to move from acute care into post-acute care will soon govern hospital discharge planning, according to the Centers for Medicare & Medicaid Services.
Transgender people are becoming more open, and case managers are likely to work with patients who openly identify as transgender. Transgender individuals are legally protected in obtaining healthcare, including transition-related care. Healthcare providers are required to treat these individuals with respect, including using their chosen gender identity.
Typically, when discharge planning involves the need for home care assistance, case managers rely on the patient’s family and friends to assist with activities of daily living. In many families, this can work just fine. But where there are odd family dynamics or if a family member is not equipped to be a caregiver, there is a need for outside help.
Hospital leaders can make the business case for patient-centered medical homes (PCMH) by using recent research from the National Committee for Quality Assurance (NCQA) in Washington, DC. NCQA reports that PCMH can increase annual revenue — and perhaps a great deal, depending on the payment model. Improvement measures are dependent on a practice’s patient population.
In October, we began our discussion on ethical issues of relevance to case management professionals. The principles should provide case managers with a framework when dealing with the tensions between providing quality healthcare and containing costs. However, it is doubtful that the tension can be overcome completely. Even when payers or health insurance plans make legitimate decisions, healthcare professionals may sometimes find that they cannot support these decisions in good conscience. How you respond to these dilemmas is significant in terms of maintaining ethical integrity.
Financial Disclosure: Author Melinda Young, Author Jeanie Davis, Editor Jill Drachenberg, Editor Jonathan Springston, Editorial Group Manager Leslie Coplin, and Nurse Planner Toni Cesta, PhD, RN, FAAN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.
