Hospital care expenses aren’t going anywhere but up, unless you—that is, professionals responsible for hospital performance—rein them in. And the pressure to do so is certainly on. The Centers for Medicare and Medicaid Services (CMS) is grading hospitals on length-of-stay and cost-per-case data, and Medicare’s move to value-based reimbursement (e.g., MIPS) has turned up the heat on performance measures.
High stakes like these put massive pressure on case management professionals to deliver an effective length-of-stay reduction strategy, while remaining patient-centric. That’s where care coordination—a demonstrated strategy to improve patient outcomes and reduce hospital stay costs—comes in, notes healthcare consultant Toni Cesta. In her audio conference for ProfEdOnDemand “Reduce Your Hospital’s Length-of-Stay & Cost-per-Case: Key Case Management Strategies,” she instructs attendees to satisfy CMS’s Efficiency Measure and boost hospital performance ratings.
- Designate a ‘Bed Czar’
Good news: Because hospital costs is so astronomically high—the average cost per hospital stay in 2012 was $10,400—if you can reduce hospital stay costs by even 1% the savings are enormous. Care coordination strategies can promote that goal by unclogging patient flow.
Do this: On-floor hospital staff already have too many overlapping responsibilities. Instead, dedicate a patient flow manager. Appoint a centralized bed authority, frequently referred to as a “bed czar,” to take responsibility for processing patient flow and ensuring smooth transitions.
Your goal is to reduce the risk of patients over-staying or experiencing delayed transfers. Ideally, a patient flow manager will help you respond to real-time demand and avoid capacity issues. The bed czar would perform key duties such as:
- Implement daily bed meetings to expedite discharge
- Lead morning bed huddles for real-time census, admission, transfer, and discharge information
- Monitor and engage units to determine staff capacity and current bed availability
- Embrace Standardization to Speed Up Transfers
Reinventing the wheel is costly and unnecessary, which is why standardizing the transfer process is a key care coordination tool to reduce hospital stay costs. Standardization paves the way for healthcare systems to perform the transfer process without hindering patient access or necessitating costly out-of-network support.
Instead: Streamline patient transfers with a standard system for all transfer-related processes. The patient transfer resource should include all relevant information for transferring patients, including staff roles and responsibilities, policies, and guidelines.
Your transfer-improvement efforts aren’t just about costs—poor transfer processes carry patient care risks, too. A study published in the Journal of Hospital Medicine discovered in-hospital mortality rates for medical inter-hospital patients were higher than for Emergency Department (ED) admission, presumably as a result of complications associated with patient transfer.
Ideally, standard transfer processes will reduce length-of-stay, cost-per-case, and decrease the risk of in-hospital death for transfer patients.
- Leverage Connectivity Tools
Finally, lean on technology. Airlines have a control tower to monitor, coordinate, and designate the flow of traffic. Similarly, healthcare systems like yours can harness the power of IT to centralize, streamline, and regulate patient flow data in real time, throughout multiple departments.
How it works: If a bed becomes available in the ED, relevant team members in inpatient/acute care and the operating room can be made aware immediately thanks to patient flow technology.
Smart IT investments include:
- RFID badge tracking for patients and caregivers. Health tech manufacturer, Quake Global, offers 7 ways to increase patient flow using RFIDs;
- Digital patient acquisition journey tracking; and
- Connected digital tools for collaborative patient assessment.
Avoid poor performance evaluations with care coordination
Case management professionals, healthcare directors, and social workers are all working toward more efficient healthcare systems that reduce hospital length-of-stay and cost-per-case. And care coordination is an essential component of any improvement effort. In her live audio event, Cesta explains specific strategies to improve your hospital’s performance and minimize cost impact. Basically, you can consider yourself the officiant to the marriage of reduced length-of-stay with successful patient outcomes, for an achievable balance that benefits all.
