July 14: Case Management
Dear Friends, let me introduce to you our Director of Case Management, Kathy Singleton. We are so fortunate to have Kathy’s leadership here at Banner Good Sam. As you know, we are always on a continual journey to ensure that our patients always receive the right care for the right reason at the right time. To do that, it takes a highly coordinated team of ALL OF US.
As Director of Case Management, Kathy and her team help play a unique role to help navigate and put the pieces of the puzzle together. I asked Kathy to write a piece from her perspective on what our current challenges, opportunities and successes have been as we continue to improve throughput, reduce readmissions, and improve coordination of care.
Thank you all for contributing daily to the Possibilities at Banner Good Samaritan Medical Center ...
Steve Narang, MD, is the chief executive officer at Banner Good Samaritan Medical Center.
Challenges, Opportunities and Successes
By Kathy Singleton, RN-BC, BSN, MSL
Director, Case Management Services
Dr. Narang offered me an opportunity to provide a perspective of our current health care environment, suggesting topics that touch on sustainable improvements, contributions by our individuals and teams, involvement by various facility staff members, and reflection on the recent changes over the past several months.
I sat back, contemplated our recent changes, and asked myself, "Are we renovating our health care delivery to our patients with new packaging and streamlined efficient production OR are we formulating and introducing new methods of patient-centered care coordination? Do we do it differently or do we do it better, or both? And what drives and sustains improved change?"
Our core essence of what our patients seek from us is delivering quality care – providing superior outcomes from the competencies that we deliver through excellent patient care, efficient services and highly motivated, engaged, knowledgeable team members, AND doing it again and again and again!
Length of Stay: We teamed together partnering nursing, physicians, case management and all other ancillary support services with a strong message that we renovate efficient processes that move the patients through the continuum of care. Nursing night staff begins the patient review for possible discharges within the next one to two days, initiates the throughput communication form, discusses the possible care plans with the case managers between 4 a.m. and 6 a.m., communicates to team leads and clinical managers before shift departure, updates the Discharge Implementation Readiness Tool (aka D.I.R.T Board) on the PCU & M/S units, huddle at 8 a.m. and then at 9 a.m. to plan the expected discharges, and then collaboratively works together to make the discharge happen. Kudos!
However, the continued success is to sustain this renovated efficient throughput process. Each individual takes ownership to Plan the Work and Work the Plan! You are an active participant in delivering quality care to our patients!
Outpatient Observation Unit (OOU): Our Transition unit has served us well in the past, ensuring we quickly moved our patients from the Emergency department into the hospital for a continued stay. Health care is shifting from volume-based services (how we count “heads in the bed”) to value-based service delivery (appropriate outpatient services versus keeping the patient as an inpatient longer than expected).
Collaboratively, the Emergency department personnel and physicians, Nursing, Patient Financial Services, Bed Control, and ancillary support services have renovated efficient throughput processes which serve our patients providing quality services. Census numbers are down, but our ability to quickly assess, triage, treat and discharge patients reduces the potential risk exposure to patients.
None of us want our loved ones in the hospital any longer than is necessary. Kudos to the team for this ongoing work! Each individual is responsible for his/her active participation in delivering quality care to our patients and sustaining our efforts.
Medical Directors of Care Coordination (MDCC): Who are they and what do they do? Drs. Anne Galvi and Raman Dhaliwal have joined the physician leadership team, providing support to our facility for coordinating care services. They are key champions for clinical and financial stewardship to the patient and the hospital and perform the following activities:
- Act as a resource for work teams for facility initiatives
- Demonstrate visibility and collaboration by directly interfacing with physicians, hospital staff and facility case managers via rounding, meeting attendance
- Optimize revenue capture by providing oversight for appropriate status determinations
- Provide compliance element for CMS Conditions of Participation by active involvement in the facility utilization management processes
- Provide oversight for moving patients through the continuum of care (throughput)
- Work with outside stakeholders such as providers of alternative levels of care (SNFs, LTACs, AIRs), payers and vendors to facilitate managing patients through the continuum of care
- Provide oversight for optimal utilization of resources to facilitate disposition
- Identify “gaps” in facility milieu and provide potential solutions to bridge the gaps
Kudos to Drs. Galvi and Dhaliwal for the collaborative efforts focusing on excellent patient care, efficient services and being a motivated and engaged team member!
All of these efforts demonstrate how our individual participation and collective teams can successfully renovate our processes with heartfelt service delivery.
Our core essence remains the same: Delivering Quality Care! The next foreboding challenge is creating an innovative environment for sustaining results! It begins with each of you, every day, making the commitment to hard-wire current processes, recognize and reward results, provide kudos at every opportunity, and making a difference in our patients' lives by continually delivering quality care! Thanks for all you do!