Part Four: Basics of Case Management, Five-Part Series-2024 Basics of Case Mgt Part 4 Presentation

2024 Basics of Case Mgt Part 4 Presentation

Pdf Summary

The Georgia Hospital Association's Case Management Boot Camp for 2024, led by Toni Cesta, emphasizes the importance of care coordination in managing patient length of stay (LOS) and the cost of care. Effective care coordination involves organizing patient care activities and sharing information with all participants to achieve safer and more effective care. It is a core responsibility of the hospital's case management department, aiming to ensure timely interventions and optimal sequence of care to improve patient safety, quality of care, and operational efficiency.<br /><br />Contemporary case management roles include care coordination, utilization and resource management, denial management, variance tracking, transitional and discharge planning, and quality management. Effective care coordination can impact several dimensions, such as patient safety, quality of care, and operational efficiency, particularly regarding LOS and cost of care. Key factors influencing LOS include documentation and coding accuracy, physician practice patterns, availability and timing of services, and effective discharge planning.<br /><br />Hospitals operate under various constraints, including payer policies where most payments are based on DRG or case rates, making efficiency in LOS crucial. Internally, operational delays due to scheduling, resource availability, or inefficient procedures can extend LOS and increase costs. Avoidable delays, whether patient-related, family-related, provider-related, or system-related, are identified and cataloged for process improvement.<br /><br />Case management's involvement in care coordination focuses on optimizing patient flow, reducing unnecessary hospital stays, and ensuring effective communication across all care stages. The ultimate goal is to improve care quality while managing costs and reducing unnecessary delays throughout a patient's hospital journey. The document outlines the need for robust coordination with post-acute care providers and emphasizes the significance of family caregivers in the continuum of care. Overall, effective case management strategies aim to streamline patient transitions and maximize hospital efficiency through advanced care coordination practices.

Keywords

care coordination

patient length of stay

cost of care

case management

operational efficiency

discharge planning

resource management

patient safety

quality of care

transitional planning