UVMC: Coordinate care, engage patients with ED case managers
Case managers can help hospitals reduce readmissions and deliver more coordinated care in the emergency department (ED), according to a new whitepaper from Huron Healthcare.
The University of Virginia Medical Center (UVMC) gave case managers a more empowered role and found they improved their ED in three ways: care coordination, patient transitions and patient engagement.
Care coordination: The case managers conduct ED flow rounds twice a day at 9 a.m. and 9 p.m., enhancing communication among all ED care team members by providing an opportunity to discuss and address any problems. They also can communicate messages to the patient, ED physician and the admitting physician.
Moreover, ED case managers collaborate with physicians on care assessments to ensure patients receive care in the appropriate setting."That approach has improved the accuracy of care assessments, which translates into better care, better reimbursement patterns, and fewer penalties, now that we're in the age of penalties for readmissions," Chris Ghaemmaghami, UVMC's medical director of the Department of Emergency Medicine, said in the whitepaper.
Patient transitions: At UVMC, case managers make sure the ED physician and admitting physician understand whether patients meet care guidelines to transition to inpatient status. They also update the care teams on transition planning so everyone is on the same page and aware of the next steps, such as a discharged patient needing oxygen delivered to his or her house or connecting a patient with community resources for follow-up care, the whitepaper noted.
Patient engagement: UVMC held ED case managers accountable for fully engaging patients and families in care decisions, which leads to higher satisfaction.UVMC's case managers can draw on their experiences as registered nurses and as a result, understand the patient's and family's point of view, Ghaemmaghami noted. They can talk to patients about everything, Ghaemmaghami said, from available transportation to outpatient treatment options to financial assistance programs and community resources.
Providing patients with such information also can help hospitals keep patients from coming back to their facilities, as a January report from the Washington Health Care Authority identified a lack of community resources as a main factor sending Medicaid patients to hospital EDs for care.
Crowded EDs can cause stress disorder, more heart attacks
Data tracking, sharing key to cutting improper ED use
4 Fierce strategies to improve ED flow
Fierce Q&A: Outpatient clinics help Lee Memorial curb ED crowding