CASE STUDY #3

observation-rates-cs3d      inpatient-length-of-stay-cs3d

The Challenge: Client is a 155 bed community hospital with an Interim Management Agreement
• Restructure Case Management Model/roles and responsibilities to optimize care coordination, appropriateness of admission status, and LOS reduction
• Decrease observation rate
• Develop physician advisor program
• Create processes to support regulatory compliance
• Educate a novice staff on case management
• Educate hospital-wide on case management

The Improvement Strategies
• Created and implemented Emergency Department Case Management role
• Implemented Physician Advisor services with detailed processes for escalation
• Implemented practices to support regulatory compliance
• Implemented daily care coordination rounds
• Implemented clinical denials program
• Completed 1:1 mentoring with staff members
• Provided Department education as well as hospital-wide education on case management and related regulatory compliance topics

The Results (6 months post implementation)
• LOS reduced by .84 days
• Observation rate reduction of 16%
• 1742 Case increase for inpatient discharges