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When health care costs for its employees soared by 60% and out-of-network claims increased by 20% in just a few years, Davis Memorial Hospital in Elkins, WV, took action. The 90-bed community hospital called on the expertise of Tod Thorpe, RN, CPC-H, its former case management director, to manage the health care of its 650 full-time equivalent employees.
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The Breakthrough Series Collaborative model effectively employed by the Institute for Healthcare Improvement (IHI) on a national level has been translated successfully to the regional level in the state of Washington, achieving significant improvement in the self-care efforts of diabetes patients and clinical improvements in areas such as blood sugar and cholesterol.
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Physicians aligned with Sutter Health in Sacramento, CA, are giving glowing reviews to a care coordination program they once failed to recognize, pleased that it is meeting myriad patients needs and saving office time in the bargain.
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After working 15 years as a discharge planner and earning masters degrees in nursing and clinical research, theres an incongruity that Diane Holland, RN, MS, MBS, who is now pursuing a PhD through the doctoral program at the University of Minnesota School of Nursing in Minneapolis, would like to resolve.
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Case managers often find themselves charged with the responsibility for solving problems without the accompanying authority needed to fix the problem. This can be very frustrating. You cant issue direct orders to solve the problem, so why should anyone listen to your suggestions?
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Through an integrated five-pronged approach, Danbury (CT) Hospital has been able to improve patient care for patients with any of 13 diagnoses. The Clinical Practice Guidelines (CPGs) include five tools: clinical pathway, standardized physician orders, patient education materials, specific discharge instructions, and critical indicators for success. Each tool is linked to the others.
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Assigning case managers to physicians rather than units has eliminated the adversarial relationship that sometimes occurs between the two disciplines and increased satisfaction among the staff and patients, says Doris Imperati, RN, BSN, MHSA, CCM, director of clinical resource management.
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All Saints Healthcare, a multifacility system in Racine, WI, has adapted a pre-existing template for meeting structure to more closely mesh with its strategic goals, creating a more organized meeting process, while at the same time, reinforcing key mission and vision messages with staff personnel.
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As government agencies begin to crack down on providers who are not honoring patient choices, hospital case managers should be more diligent than ever when referring patients for post-acute services.