Post on 31-Dec-2015
Cost Containment• Residents and MD’s• Pay attention to correct
inpatient orders• “Admit as Observation”• “Admit as Inpatient”• NO SOCIAL ADMISSIONS
ALLOWED!• “D/C if OK w/ PT/OT” only
works if going home—Not needed for ECF.
• Watch for Avoidable Delays.
• Write discharge orders 24hrs prior to planned D/C.
• Involve social work services early.
• Move to correct level of care when criteria changes.
• Business rounds helpful.• Need D/C orders early
Friday for W/E DC’s to precert before the W/E
Outcome ManagementConsists of Bachelor’s prepared
Registered Nurses called “Resource Utilization Coordinators” (RUC’s)
RUC’s role REVIEW CHARTS:
Appropriate Inpatient orders (OBV vs IA)
Appropriate use of resources
Monitor and report Avoidable Delays (AVD’s)
Report to SW/SWA any potential discharge needs
Monitor Readmissions
Collaborate with Licensed Social Workers and Social Work
Assistants:Screening and Assessments for D/C needs
Discharge PlanningCrisis Intervention
D/C Resource Experts
Dollars Lost by Category
$-
$20,000
$40,000
$60,000
$80,000
$100,000Ap
r-07
May-0
7Jun
-07 Jul-07
Aug-0
7Sep
-07Oc
t-07
Nov-0
7De
c-07
Jan-08
Feb-0
8Ma
r-08
Apr-0
8Ma
y-08
Jun-08 Jul-08
Aug-0
8Sep
-08Oc
t-08
Nov-0
8De
c-08
Jan-09
Feb-0
9Ma
r-09
MD Dollars Lost System Dollars Lost External Dollars Lost
OBV graphObservation Cases
FY 08
5159
5347 45
60 5775
40
5153
0
20
40
60
80
100
120
140
160
180
200
Nu
mb
er
of
Ca
se
s
Hospital Acquired Conditions
• Complete the History and Physicals
• Remember to document what is present on admission:– UTI– Skin breakdown– pneumonia– Etc.
Patient Communication
• Patient Satisfaction relies on good communication between you and:
• the patient & their families• the patient’s nurse• OTM• GOOD PATIENT CARE BEGINS WITH YOU!
ATTENTION TO ALL PHYSICIANS!!!!• ADMIT ORDERS & MEDICARE COMPLIANCE
• Admission Orders need to be specific for STATUS of INPATIENT or OBSERVATION
• Appropriate Status Order: “ADMIT AS INPATIENT”– “ADMIT AS OBSERVATION”
• Inappropriate Status Order:– “ADMIT TO floor________”– “ADMIT TO Dr. ____________”