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It's nothing new. Compliance with verbal orders has been a struggle for hospitals for more than 25 years. Many experts Hospital Peer Review spoke with compare verbal-order compliance to hand-washing compliance. It's behavioral. It's something we know we have to do. And it's not a matter of ill-intentioned practitioners. It's a matter of time and logistics.
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Case managers typically have concentrated on what has to happen before the patient can be discharged from the hospital, but now, to reduce readmissions, hospitals also have to take into consideration what happens to patients after they leave the acute care setting, says Beverly Cunningham, RN, MS, vice president, clinical performance improvement, Medical City Dallas Hospital, and health care consultant and partner in Case Management Concepts LLC.
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Case managers are a hospital's first line of defense when it comes to smoothing transitions of care and preventing readmissions.
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The Medicare Secondary Payer questionnaire is not complete. The Medicare number is missing from a replacement plan. The subscriber name or date of birth is a mismatch. An account has incorrect insurance coded for third-party liability.
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In preparation for the Recovery Audit Contractors (RACs) and to improve patient flow, Durham Regional Hospital redesigned its case management department and moved to a triad model of patient care.
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By redesigning its case management program and beefing up technology, Saint Thomas Health Services reduced the average length of stay systemwide by 0.20 days and saved more than $6 million in just two years.
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In an effort to ensure that the patients most vulnerable for readmission stay safe at home after discharge, Lutheran Medical Center is developing a pilot program with a local home care agency to provide at least one home care visit for the majority of congestive heart failure patients going home with no services.
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If you haven't started analyzing your hospital's readmission rates and the role case managers can play in reducing readmissions, it's time to start so your hospital can avoid penalties from the Centers for Medicare & Medicaid Services (CMS).
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As part of the ongoing education to prepare for Medicare's Recovery Audit Contractors (RAC) program, Cynthia Lawson, RN-BC, MBA, CPHQ, director of case management at North Hills (TX) Hospital is teaching her case management staff to think innovatively when reviewing charts.
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A combination of face-to-face and telephonic case management has resulted in high patient satisfaction ratings and a significant decrease in health care utilization for patients with complex medical needs.