CASE STUDY #4

The Challenge: Client is a large >600 Bed Academic Medical Center with a Case Management Re-design Initiative
• Optimize care coordination and discharge planning to reduce hospital-wide LOS
• Reduce/eliminate redundant and inefficient processes
• Engage all physicians, including voluntary attending physicians

The Improvement Strategies
• Focused attention and encouraged physician and case manager interactions
• Implemented a Physician Advisor Program
• Integrated the roles of utilization review and care coordination nurses
• Established a centralized support center to streamline back-office activities
• Enhanced and improved utilization of current technologies
• Provided educational modules to prepare staff for newly designed roles
• Streamlined case manager processes
• Implemented daily care coordination rounds
• Implemented compliance management processes

The Results
• Exceeded annual length of stay goal within the 1st quarter post implementation resulting in an $800K opportunity day savings
• Improved compliance with completing clinical reviews within the first 24 hours of admission by 50% during 1st quarter
• Drove revision of current corporate compliance policy to reflect new regulatory standards. Projected to have a $3M impact to bottom line
• Decreased denial write-offs $158K within 1st quarter