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Monday, July 30, 2012
  Clinical Accuracy Spoken Here  

Principles of CM: Clinical Outcomes

Transitional/discharge planning commences on the day the patient enters the inpatient facility, but evaluating the success of the plan should not wait until the patient is discharged. All of the care goals and outcomes should be monitored on a regular basis and updated as needed.

Some of the goals will be short term by definition (e.g., discuss preparation for the barium swallow scheduled for tomorrow) and need to be indicated as met when they occur.

[Reference: Principles of CM, Module A, Principles]

  Excellence in Case Mgmt  

Principles of CM: Communication with MD is "Best Practice"

From the perspective of the Joint Commission, access to the appropriate level of care is a product of case manager-to-physician communication before a patient is admitted to the acute care facility.

Communication between the hospital case manager and either the ED physicians, the physician on-call, or the patient's attending physician remains the best practice for ensuring that an initial assessment confirms the patient's need for acute care, treatment, and service.

[Reference: Principles of CM, Module A, Principles]

  Improving Patient Care...  

Principles of CM: EDCM Improves Revenue Stream

Some Emergency departments (EDs) have tried teaching ED nursing staff how to evaluate patients for observation vs. inpatient status and to deal with other traditional case management (CM) responsibilities. These additional activities have proven overwhelming and inappropriate.

Case management in the ED has dramatically improved the flow of patients through the ED and the accuracy of placing patients into the correct level of care. Because patients are discharged to the correct Level of Care (LOC), hospitals have seen improvements in their revenue stream, since inpatient denials have decreased.

[Reference: Principles of CM, Module C, EDCM]


Tom RasmussenTom Rasmussen
Athena Forum


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