Case Management Consulting

Hospital operational efficiency and emergency room consulting

CASE MANAGEMENT CONSULTING

Balancing Quality and Cost of Care

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The Sullivan Lakier Group understands the importance of the Case Management function in the provision of high quality and cost effective patient care. Our seasoned consultants utilize an individualized approach so the level of consulting provided is what your hospital needs. We partner with your staff so that we pass on knowledge that positions your hospital to sustain the gains.

Our goal is to help you ensure that:

access utilization is effectively managed,
the right care is provided,
the physicians’ and clinical teams’ communication and documentation is effective, and
all earned revenue is captured.

CASE MANAGEMENT CONSULTING SERVICES:

We utilize a four step process in our consulting which is tailored to the level of support you need. These four steps typically are as follows;

Evaluate your entire case management system or specific areas identified and make recommendations for improvement
Develop an action plan to guide the improvement work for either your team or a combined hospital-consultant team
Provide project leadership or hands-on support for implementation as needed
Provide an operations dashboard and training that allows the organization to monitor and ensure the gains are maintained.

The areas of focus for a Case Management assessment typically fall into the following categories:

Cost of care by DRG and Physician
Payor mix and case mix index
Readmission rates
Patterns of care for the high-risk or high cost patient volumes, e.g. CHF, Diabetes, Heart Disease, COPD/Pneumonia, etc.
Resource Utilization
Standardization of Care
Case Management Model
Patient progression or patient flow
Same Day Surgery
Observation Stay Patients
Inpatient “holds” in ED and PACU
Clinical Documentation Practices
Use of Case Management tools such as:

Clinical pathways
Evidence-based practice guidelines
Multidisciplinary team rounds

BENEFITS OF OUR CASE MANAGEMENT CONSULTING SERVICES:

We will work with you to develop and implement strategies that result in:

Decreased LOS and decreased cost per case
Improved management of high-risk , high cost case types
Decreased recidivism rates
Improved physician management of LOS, utilization of services and cost of care
Integrated Case Management Model
Improved continuum of care
Optimize Same Day Surgery Patient status and LOS
Optimize Observation Stay Patient LOS
Reduced Emergency Department LOS
Improved Patient Flow
Optimize admission status assignments to maximize reimbursement
Improved clinical documentation to support management of care and reimbursement
Improved quality of care outcomes

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