Case Management

Expediting discharges with a case manager–nurse practitioner model

Case Management Monthly, August 1, 2009

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Organizing and executing discharges in a timely manner at a busy teaching hospital is quite an overwhelming responsibility.
Nancy Kays, RN, CM, faced this task each day at Massachusetts General Hospital (MGH) in Boston. Kays coordinated discharges with residents who were also trying to care for patients, attend meetings, and teach interns.
When the hospital made a goal of getting all discharge patients out by 10 a.m., it was not possible for Kays and the residents to keep up.
“It’s so hard for residents to stop and do all the paperwork required for two or three or even one discharge,” says Kays. “Even if you do some of the paperwork the night before, it still takes time to make sure the medications are correct, the appointments are correct, setting up post discharge x-rays, etc.”
MGH made 10 a.m. discharges a priority and looked into creative options to help Kays and the rest of the team succeed.
As a result, assistant chief nurse Theresa Gallivan, RN; Hasan Bazari, MD, the internal medicine residency training program director and assistant chief of medicine; and Andrew Karson, MD, the director of the clinical decision support unit, used grant money to hire a nurse practitioner, Karen ¬Pickell, ANP-BC.
The original goal was to have Pickell manage several patients for the team and assist with the discharge paperwork process to help with the hospital’s goal of getting patients discharged by 10 a.m.

 

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Case Management Monthly.

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