In one mid-sized community hospital, technological limitations, communication failures, and inadequate training of personnel lead to a system in which cases were handled inefficiently. This resulted in long stays and low levels of reimbursement. Compass Clinical Consulting deployed an interim Director of Case Management to provide leadership in addressing these issues.
CRAFTING A SOLUTION
The interim Director of Case Management first worked within the hospital’s culture to break down communication silos along the case management chain. In addition, a revised schedule for case managers and social workers was created. Admission and review processes were standardized, and increased communication between clinical and financial departments ensured that medical records accurately represented each patient’s condition to optimize reimbursement.
SEEING THE RESULTS
Better communication allowed team members to better understand each other’s roles, regulatory changes, and the financial constraints that third parties placed on the healthcare system. Likewise, revised schedules provided for consistent coverage and appropriate case loads for all personnel involved in case management. As a result of these small changes, the hospital improved reimbursement and reduced its length of stay from 4.8 days to 3.6 days, leading to dramatic reductions in associated costs. Says the hospital’s Chief Nursing Officer,
“Your interim Director of Case Management’s tremendous knowledge base and skills … allowed our hospital to fundamentally change how we viewed and structured our case management department and each person’s core functions. Our length of stay is down to a five-year low for three consecutive months.”