Case Management

Sneak peek: Tips for educating medical staff on level of care

Case Management Weekly, April 27, 2011

Efforts to educate medical staff members on Medicare or other payer policies can be like herding cats. However, it is necessary to ensure compliance. The case management department cannot improve level of care decisions without cooperation from medical staff members.

There is no magic bullet for effective medical staff education, but here are a few suggestions:

  • Get their attention with data. Use public ­report cards and brief, colorful graphics. Tell a clear story that can be understood in a short time period. Design the presentation so staff members know what the issues are and have a sense of the action needed without requiring extensive explanation.
  • Focus on medical decision-making for level of care decisions rather than screening criteria.
  • Do not begin an educational opportunity by saying, "This admission does not meet ­criteria." ­Consider asking the physicians to provide ­information that will ­allow an auditor to better understand why the patient was admitted as an inpatient. Show physicians how an incorrect ­level of care determination affects the ­patient. Many physicians are amazed to learn that an inappropriate outpatient surgery or observation order will ­increase the cost to the patient-they often think the opposite is true.

Check out the May 2011 issue of Case Management Monthly to learn more. You also can discover the benefits of becoming a Case Management Monthly subscriber.

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