Part Five: Beyond Basics of Case Management Five-Part Series (ODW5012PT5)-Beyond Basics of Case Management Five-Part Series, Part Five Recording

Video Transcription

Video Summary

Dr. Toni Sesta, a founding partner of Case Management Concepts, LLC, discussed the critical role of case management departments in healthcare institutions. With over 25 years of experience, Dr. Sesta shared insights from her research on case management's impact on patient outcomes, particularly around congestive heart failure and hip fracture cases. The session emphasized the significance of outcomes in case management, challenging attendees to consider how outcomes data influences leadership and staff at both the departmental and organizational levels. <br /><br />Dr. Sesta underscored that measuring outcomes helps in assessing department effectiveness concerning cost and quality impacts. She outlined various metrics, such as key performance indicators (KPIs), emphasizing their importance in demonstrating the value of case management. These metrics include understanding financial outcomes (like length of stay and cost), quality outcomes (such as unnecessary readmissions and patient satisfaction), and service outcomes (like discharge delays and patient experiences).<br /><br />She stressed that tangible data support is crucial for senior leaders to make informed decisions and ensure case management activities align with broader organizational goals. The discussion included recognizing case management as a cost avoidance department rather than a cost generating one and highlighted the need for strategic planning in connecting patients to community resources. Dr. Sesta also discussed the role of physician advisors in denial management and emphasized consistently reviewing benchmarks to evaluate performance. The session highlighted the ongoing need for improvement and adaptation in case management practices to align with evolving healthcare standards and regulatory requirements.

Keywords

case management

healthcare institutions

patient outcomes

congestive heart failure

hip fracture

outcomes data

leadership

key performance indicators

financial outcomes

quality outcomes

service outcomes

cost avoidance

physician advisors

strategic planning