CASE MANAGEMENT INSIDER. Re-Engineering Your Case Management Department: It's Simple, It's Just Not Easy, Part 1.

This month, we have begun our discussion of the reasons why this is a very good time for hospitals to review and re-engineer their case management models and departments, including the Affordable Care Act and value-based purchasing, among others. Next time, we will discuss the elements you need to review when re-engineering your own case management department.

Making the Two-Midnight Rule Work for You.

While the Two-Midnight Rule can be confusing to staff and patients alike, if you implement and hardwire your processes you will be more likely to maintain compliance going forward.

CASE MANAGEMENT INSIDER. Case management's role in the new proposed bundled payment program.

The CCJR program is a complex one. It is important that case managers, social workers, and case management leaders educate themselves on the program and what they can do to be successful partners in this process. Use total joints as a pilot to prepare for future bundles.

CASE MANAGEMENT INSIDER. Thinking of Separating Utilization Management and Case Management? Think Again!

Case management should be designed as a fully patient-centric model with all the roles and functions of the case manager and social worker performed as part of a package of services provided to the patient, not as a series of tasks that are disjointed and performed in isolation of each other. When case management models separate these roles, they create an environment in which these roles no longer interface and no longer are applied with the patient's current and long-term care needs in mind. Be very cautious when implementing such models and as you can see above, the argument that the collaborative model is less expensive simply does not hold true.

Interdisciplinary Walking Rounds: A Key Strategy for Improving Case Management Outcomes--Part 2.

The role of interdisciplinary care rounds has never been more vital to the success of healthcare institutions. As the Centers for Medicare & Medicaid Services continues to strive to equate reimbursement with quality of care, hospitals will need to find new ways to deliver care that achieve these goals and have a positive effect on the bottom line The notion of rounds is not a new one, but taking rounds to the bedside on all patient care units is. Critical care areas have used this format for years, but it is now time for this effective process to be taken to the bedside of each and every hospitalized patient.

Interdisciplinary Walking Rounds: A Key Strategy for Improving Case Management Outcomes--Part 1.

This month, we began our discussion of walking rounds with an overview of why rounds are important and how you might begin to structure rounds in your organization. Because IHI and TJC both identify walking rounds as best practice, we have focused our discussion on the elements needed for a successful walking rounds process. Next month, we will continue our discussion of walking rounds with strategies for preparing for rounds, as well as how to engage the patient and family in the rounding process.

CASE MANAGEMENT INSIDER. The Top 10 Mistakes You May Be Making In Your Case Management Department! Part 4.

We have now completed our review of the top 10 mistakes you may be making in your case management department. I've included tips and strategies for correcting these mistakes if you are facing them in your organization. If you follow these suggestions, you will help to keep your case management practice and your department on track and moving forward!

CASE MANAGEMENT INSIDER. The Top 10 Mistakes You May Be Making In Your Case Management Department! Part 3.

This month, we reviewed three additional mistakes that are commonly being made in case management departments in hospitals today. Next month, we will review the final three of the top mistakes that you may be making in your department.

Case Management insider. The top ten mistakes you may be making in your case management department!: Part 1.

This month we have begun reviewing the top mistakes hospitals make within their case management department's infrastructure. As discussed, the biggest mistake is to not clearly and prospectively define the roles of the RN case manager and the social worker to optimize each discipline's skill sets. Associated with this mistake is to have inadequate patient ratios assigned to each discipline.

Case management insider. C-suite executives: the final frontier for hospital case management.

In order to sit at the table with your organization's leadership and make credible arguments and a sound business case for the resources you may need tomove your department forward, remember that you need to be as well versed as you possibly can be. Anecdotal thoughts and opinions will not get you the resources you need. Best practice information will be a much better tool for making the case and having it stick.

Case management insider. The new value-based purchasing efficiency measure: are you ready?

The CMS efficiency measure has once again raised the issues of length of stay management and cost reduction. These have always been a component of the role of the hospital-based case manager. In today's best practice models, these interventions must be correlated with the roles of coordination and facilitation of care, discharge planning and utilization management.

Case management insider. Home health care--a key component of discharge planning.

Home care is an important intervention to consider for virtually every patient you discharge to home. By using the strategies discussed above, you can increase your percentage of patients going home with this important service. Remember to assess every patient on admission and to reassess every patient daily.

Case management insider. Family caregivers: a key component of the discharge planning process.

The role of the family caregiver may not be for a short time period. It could go on for months or even years. As case managers, our role is to ensure that we have provided our family caregivers with all the information that they may need to care for their loved one at home or in another care setting.

Time management for case managers--so much work, so little time.

The world of a case manager is a busy one, and you may not have all the resources you need each and every day. If you can maintain a routine it will make the workload more manageable for you and will allow room for those surprises that invariably happen. Whether you are a new or a seasoned case manager, organizing your workload can always help smooth out the rough edges in anyone's hectic day!

Community case management -- thinking beyond the hospital walls.

Case managers must approach the case management process as one that focuses across on the continuum of care and addresses inpatient as well as community needs. Case management assessments must go well beyond just the issues of discharge destination, but rather connect the care providers across the continuum in new ways that will improve outcomes for patients and reduce cost for the healthcare industry.

Case management insider. Patient transitions--it's not just discharge planning anymore.

Hand-off communication provides an important link for patients and care providers as patients transition across the continuum of care. make it part of your everyday practice!

Case management insider. The 2-midnight rule--a game-changer for case management.

As a case manager or case management leader, it is important for you to stay in touch with how CMS continues to roll out the two-midnight rules as well as the manner of auditing on a go-forward basis. It is also important that your department continue to have a close working relationship with the billing department in your hospital to ensure that the hospital remains compliant with this new rule. Finally, it is also critical that your emergency department and its physicians are kept up to date on the rule and its implications for hospital admissions.

Case management insider. Centers for Medicare and Medicaid services--conditions of participation for utilization review.

As case managers, the UR plan and the CoP are important tools that guide our daily work. It is important to be familiar with all CoPs that apply to case management and to review these on a regular basis!