Posts Tagged ‘emergency medicine’

Infographic: How EMS Can Help Reduce Gaps in Care

May 18th, 2016 by Melanie Matthews

Emergency management services (EMS) can fill gaps in the care continuum with 24/7 medical resources that improve the patient care experience, improve population health, and reduces costs, according to the National Association of Emergency Medical Technicians (NAEMT). EMS is uniquely positioned to support healthcare transformation by assessing and navigating patients to the right care, in the right place, at the right time.

NAEMT created an infographic to explain the EMS role in healthcare transformation and how EMS can expand its services to fulfill this new role.

Yale New Haven Health System (YNHHS) takes an on-site, embedded face-to-face approach to coordinating care for its highest-risk, highest-cost patients—whether identified within its own employee population, inside a patient-centered medical home (PCMH), or among the geriatric homebound. The Connecticut-based health system believes this vision of care management is the most direct path to success in a value-based healthcare industry.

In 3 Embedded Care Coordination Models to Manage Diverse High-Risk, High-Cost Patients across the Continuum examines YNHHS’s three models of embedded care coordination that deliver value while managing care across time, across people, and across the entire continuum of care.

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Meet Case Management Manager Helen Schreiber: Dispelling the Notion of “Nurse Police”

June 29th, 2012 by Cheryl Miller

Helen Schreiber RN, BS, CCM, Executive Vice President of S&H Medical Management Services, Inc.

HIN: Tell us a little about yourself and your credentials.

Helen Schreiber: I attended nursing school after getting married and having two kids. I took all of my science classes at the junior college level while I was working part-time at a deli. I knew I was going to attend a diploma program because I couldn’t afford to go to a four-year university. Unfortunately, at that time, hospital programs would only accept you if you were single. I had faith and sure enough, after being told in 1979 and 1980 that I could not be married and attend, in 1981 I was told that I could attend if I lived in the dorm, and then Ravenswood Hospital School of Nursing finally accepted me in 1982 and allowed me to commute. There were 88 students in my class and more than half of them were married with kids. I graduated from there in 1985. I then received my bachelor of science in health arts (BSHA) from St. Francis in 1991. I am currently a certified case manager (CCM). Prior to that I was a Mobile Intensive Care Nurse (MICN), a Certified Emergency Nurse (CEN) and a Trauma Nurse Specialist (TNS).

What was your first job out of college and how did you get into case management?

I worked nights on an ortho unit (22 patients on my team) and then moved on to my dream job in the ER. I loved working nights there. When my kids got older I knew I needed to work days and I found an ad for a case manager.

Has there been a defining moment in your career? Perhaps when you knew you were on the right road?

I was truly in my element in the ER. I loved the fact that you could never predict how your shift would end. I love the chaos…and case management fills the same needs for me. Plan but be prepared for any eventuality.

In brief, describe your organization.

S&H Medical Management Services, Inc. is an independent, regional, women’s owned medical and vocational case management firm. We are completely virtual! I am most proud of the fact that we have 12 S&H babies. By that I mean, kids that were not in child care because of our at home positions with flex hours.

What are two or three important concepts or rules that you follow in case management?

  • First and foremost, be honest.
  • The second most important thing is realizing that the availability of healthcare is a gift. It is there for the patient to accept. You can wrap it up and make it as attractive as you can but you cannot make a person open the gift. That is very difficult for some people to accept.

    What is the single most successful thing that your organization is doing now?

    We have the best vocational department in Illinois. At a time when jobs are being lost, our vocational staff continues to produce a product that rocks. We have doubled the size of our vocational department during the past two years and it is due to great outcomes and special people.

    Do you see a trend or path that you have to lock onto for 2012?

    The economy continues to impact this industry. I believe creative marketing is key at this time.

    What is the most satisfying thing about being a case manager?

    I truly feel humbled to have people allow us into their lives and share the details with us at such a stressful time. That is the best thing about being a nurse.

    What is the greatest challenge of case management, and how are you working to overcome this challenge?

    Involving the injured worker into the process and making certain that the case manager is honest with him is what is most beneficial to the process. Many times the case manager is perceived as the ‘nurse police’. Those words were spoken to me by an injured worker…..

    What is the single most effective workflow, process, tool or form case managers are using today?

    At S&H I believe our proprietary software for case management documentation has made our staff more effective. S&H has also adapted the CMSA adherence tools and we utilize these tools to assist with adherence assessments.

    Where did you grow up?

    I was born in Austria. My family immigrated to the United States when I was 18 months old. I grew up in Chicago and became a U.S. citizen in the early 60’s. I attended Good Counsel high achool.

    What college did you attend? Is there a moment from that time that stands out?

    I am a child of the 70’s when not everyone went to college – at least not right away. I will never forget how overwhelmed I was when I first went to register at Wright Junior College in Chicago for my very first college course. The hardest thing to do is to go back to school. I remember telling my boss that I would be 33 by the time I finished school. He said you will be 33 in five years anyway.

    Are you married? Do you have children?

    I have been married to Roland Schreiber for 35 years. It is a second marriage for both of us. We have two kids: Erik is 38 and a cop in Chicago. Monika is a teacher, married to Pat and they are the parents of my two terrific grandchildren, Elizabeth and Olivia, who all live in Texas. We spend winters there in order to spend more time with the girls. While my daughter is certified as a teacher she now works for S&H and has since college. This has allowed her to work from home.

    What is your favorite hobby and how did it develop in your life?

    Sewing when I have the time. My current project is new drapes. And I am absolutely crazy about dogs. We currently have three, Gretchen the golden retriever, Schatzi, the rescue (a German Shepherd mix) and Tinker, another rescue (a Shitzu).

    Is there a book you recently read or movie you saw that you would recommend?

    The Total Money Makeover by Dave Ramsey is a great book. It helps people learn to live debt-free and have more control of their lives.

    Click here to learn how you can be featured in one of our Case Manager Profiles.

  • UPMC Home Visits Target Unplanned Care in Emergency Departments

    June 18th, 2012 by Jessica Fornarotto

    UPMC members who treat the ER as a primary care provider can expect a home visit from the health plan’s community teams of nurses and social workers. Community teams visit these members at home to perform assessments and care management.

    That’s one of the ways UPMC Health Plan is reducing the rates of avoidable emergency room use, according to Debra Smyers, senior director of program development at UPMC, who presented these strategies during a recent webinar on Identifying, Engaging and Breaking Down Patient Barriers To Reduce Avoidable ED Use.

    UPMC developed community teams to engage members who were having “unplanned care” — members who thought of the ER as their own personal PCP. These teams focus primarily on the Medicaid and special needs populations. UPMC sends health plan nurses and social workers into the community to visit the targeted members in their homes. These visits continue for a few months. Then, the nurse or social worker hands the member over to a different caregiver to continue the care.

    UPMC calls it a “real team approach;” they even have nurses located in the patient-centered medical home (PCMH) who can link members to an appropriate caregiver, explains Ms. Smyers. For instance, if the member is a smoker and wants to quit, the nurse would link that member to the lifestyle health coach who helps with smoking cessation.

    UPMC Health Plan has also placed a patient navigator in the ER to educate patients on appropriate ER use. These navigators ask patients coming into the ER for a minor illness, such as for a sore throat, if there are any care alternatives they could use instead, such as visiting their PCP. Should the patient not have a PCP, the navigator will then help the patient to find one.

    Originally, to identify patients using the ER inappropriately, UPMC would go through a monthly stratification process that included data from previous months. However, this identified patients too long after their ER visit, when it was irrelevant to help the patient. The health plan now uses actual registration data from the ERs to find their targeted patients.

    With this new plan, UPMC was then able to reach the patient about their ER use on the actual day of the hospital visit. Also, to have a more direct focus on the different patients that were coming into the ER, UPMC stratified all patients into three targeted groups: those with high ER use, those with ER visits for conditions, and those patients with level 1 or 2 ER visits.

    Smyers also discussed UPMC’s Connected Care Program to help improve care coordination for patients with serious mental illnesses. The health plan based this program on the PCMH model of care to address how physical and behavioral healthcare providers can manage the care of this specific population.

    One of the components of this program is integrated care team meetings with staff members to focus on how to support patients with their personal and social needs. For instance, if a patient is constantly going to the ER for an illness only because the ER staff treats them well, the patient needs to understand why that constitutes inappropriate use of the ER.

    This UPMC program engaged 2,500 members over two years.

    In 2010, UPMC added an ER measure to their pay-for-performance (PFP) program. This measure is made up of two parts: one looks at utilization of the ER in comparison to other practices in the PFP program, and the other part looks at the rate of the practice’s improvement from the previous year.

    One of the many outcomes from the ER measure was that in 2011, the PFP practices had a rate of ER visits of 34/1,000 less than the overall performance and 145/1,000 less than the non-PFP practices.