Posts Tagged ‘discharge planning’

Integrated Case Management Scripts Keep MSKCC Patient Care Team on Same Page

February 1st, 2018 by Patricia Donovan
Healthcare Scripting

MSKCC scripting improved the consistency of patient communication and staff efficiency.

To help ensure its patients receive consistent messages, Memorial Sloan-Kettering Cancer Center (MSKCC) has developed a series of scripts for use by its integrated case management team. Here, Laura Ostrowsky, RN, CCM, MUP, MSKCC director of case management, describes some scripting scenarios employed by the state-of-the-art specialty hospital.

There are a variety of ways we’ve done scripting. For example, there was a time when a case manager would meet with a doctor and the doctor would say, “I think we need to set up hospice for this patient.” The case manager then would go into the patient’s room and say, “I’m here to help you to set up your discharge plan. I know you’ll be going to hospice.”

And then the patient would say, “What are you talking about?”

One thing all case managers know is that when you go into a patient’s room, especially if someone told you they said something to the patient, you first must confirm what the patient understands about that previous conversation. If it turns out that they didn’t understand what you were told to talk about, then you don’t have that conversation. You go back to the staff member that sent you in there and discuss it. Perhaps you schedule a family meeting to discuss that issue.

We also developed scripts not only for preadmission staff, but for all staff trying to get approvals from insurers for high-cost medications and for procedures. We work with them to identify how to answer questions from the insurance company or insurance case manager so that those tasks can be handled by the doctor’s office or admitting department rather than by case management.

The approach of our length of stay reduction teams, while not exactly scripted, is concerned about consistency of message. The teams came up with the steps and planned the patient education material with the imperative that we never overestimate a length of stay, but rather err on the short side.

The imperative is that everybody speaks to the patient the same way. The case managers make a point to tell the team, “Don’t make promises we can’t keep.” That’s not exactly scripting, but it keeps everybody on the same page. For example, don’t tell a patient they are going to have plenty of help at home. Or that they will get home care and someone will be there every day, because you don’t know if that is going to happen.

Instead, you can say to the patient, “We are going to see if you are eligible for home care. I am going to send the case manager in to see you. They will check your benefits and go over eligibility. We will do our best to get you the services you need.”

Source: Integrated Case Management: Elevating Quality and Clinical Metrics with Multidisciplinary Team-Based Care

integrated case management

Integrated Case Management: Elevating Quality and Clinical Metrics with Multidisciplinary Team-Based Care details the framework and implementation of the service-based multidisciplinary program MSKCC adopted to ensure that the care it provides to more than 25,000 admitted patients each year is both cost-effective and cost-efficient.

2015 Healthcare Headlines: Top Stories Trace Route to Value-Based Reimbursement and Care

December 28th, 2015 by Patricia Donovan

Month by month, the industry's top stories confirmed that value-based innovations and collaborations are here to stay.

A look back at the year’s top healthcare stories captures the industry’s commitment to enhance the quality and efficiency of care delivered while reining in cost. Nearly all of HIN’s most-read stories fell into one of two categories: announcements of new value-based models or pilots, or results from existing quality-focused initiatives.

Here are the stories that captured the attention of healthcare executives in 2015:

HHS Announces Timetable, Goals for Medicare Value-Based Reimbursement
Medicare kicks off 2015 with the rollout of an ambitious multi-year agenda for a shift to value-based reimbursement and alternative payment models.

Cigna Collaborative Care Reduced Avoidable ER Visits by 16 Percent
The February release of Cigna’s second-year results from a collaborative care initiative with Granite Healthcare Network documented significant progress in improved health and affordability.

2015 Hospital Market Will Hasten Transition to Value-Based Payment Business Model
The early 2015 economic outlook for the hospital industry continued to favor the largest, most geographically diverse health systems in the market, according to this January 2015 forecast from BDC Advisors.

Medicare Discharge Planning Proposed Rule: More Focus on Patient Preferences, Follow-Up Care and Communication
CMS proposed in October a revision of discharge planning requirements that hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies, must meet in order to participate in the Medicare and Medicaid programs.

Senate’s Repeal of Medicare Sustainable Growth Rate Strengthens Move Toward Value-Based Physician Reimbursement
April 2015 saw the U.S. Senate’s landmark repeal of the Medicare Physician Payment Reform Bill, otherwise known as the Sustainable Growth Rate (SGR), a mechanism used to calculate Medicare payments to physicians.

One-Fifth to Launch ‘Next Generation ACO’ in 2015
Twenty percent of healthcare organizations plan to participate in CMS’s new ‘Next Generation ACO’ model in the coming year, according to 2015 Accountable Care Organization metrics compiled in May.

8 Wellmark Medicare ACOs Saved $17 Million in 2014, Boosted Quality by 8%
September saw the release of Wellmark Blue Cross and Blue Shield’s 2014 Accountable Care Organization (ACO) Shared Savings model data, in which eight participating ACOs improved their overall quality scores by 8 percent and saved more than $17 million during 2014.

CMS Launches New ACO Dialysis Model
CMS announced in October its Comprehensive ESRD Care (CEC) Model, designed specifically for beneficiaries with ESRD and built on lessons learned from other models and programs with ACOs, including the Pioneer ACO Model and the Medicare Shared Savings Program.

Final Rule for Joint Replacement Bundled Payments Favors Composite Quality Score
In November, CMS finalized its Comprehensive Care for Joint Replacement (CJR) model, set to begin on April 1, 2016, which will hold hospitals accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements and/or other major leg procedures from surgery through recovery.

Geisinger Pilots Patient Experience ‘Warranty’ for Select Surgeries
The Pennsylvania health system generated headlines in November with the launch of its innovative ProvenExperience™ warranty, a program that keeps the patient experience front and center by offering refunds to patients undergoing select surgical procedures whose expectations weren’t met based on kindness and compassion.

To stay abreast of the latest healthcare headlines in 2016, subscribe free to HIN’s Healthcare Business Weekly Update.