Case Management

See the discharge process through the patient's eyes

Case Management Monthly, April 1, 2010

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The advent of the DRG system gave hospitals an incentive to decrease LOS. The average LOS is two days shorter than it was 15 years ago, says Greg Nelson, president of Baptist Leadership Group (BLG) in Pensacola, FL.

Stefani Daniels, RN, MSNA, CMAC, ACM, managing partner at Phoenix Medical Management, Inc. in Pompano Beach, FL, says financial implications are not the only reasons to reduce LOS. The acute care setting is a high-risk environment, and patients are safer in a lower level of care or at home.

Regardless, the reduction in LOS has made the discharge process critical. Patients and their families now change wound dressings, administer medications, and monitor progress. “We expect patients to serve as their own little case managers,” Daniels says. “And in most cases, it is unrealistic.”

Case managers and discharge planners must reinforce the discharge plan, make sure that patients clearly understand the discharge instructions, and follow up with patients so they remember what their instructions are.

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