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CMW Sneak Peek: Rewiring the discharge planning process

Case Management Weekly, September 3, 2008

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Sutter Health Sacramento Sierra Region in California recognized there was room for improvement in the discharge planning process of its four acute care facilities. LOS was increasing, and case managers felt stressed and overwhelmed. To improve its LOS data, and to assist the overworked case managers, the organization decided to hire help by adding a support role it called “case management specialist.”

To fill this role, Sutter Health looked for individuals who had educational preparation of at least an associate’s degree, knowledge and experience of the healthcare field, and excellent written and oral communication skills. When the role was first implemented, the case management specialists reported to one RN case manager per case and worked on three or four cases at once.

During the initial part of the program, although the footwork was taken away from the case manager, the Sutter Health team recognized the specialist role could be more independent. And when the numbers showed that one of the four Sutter Health facilities, Sutter Roseville Medical Center, was still underperforming despite the added case management specialists, Kim E. Miller, RN, case management education coordinator and the interim director of Sutter General Hospital, and colleague Karen Dunning, RN, regional continuum case management educator, were called upon to further change the discharge planning process. They gathered all the staff members in a room and asked them for ideas.

“We identified where the waste was and where the gaps were—the ‘non-value added’ activities,” Miller says. They even timed the case managers to see how long activities took them each day, from planning their day to performing utilization review (UR).

Check out the August 2008 issue of Case Management Monthly to get the full story, and check out all the benefits of being a Case Management Monthly subscriber!

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