Interim Management Case Study
THE CASE: Angel Medical Center, Franklin, NC
The Challenges:
QHR’s analysis of case management surprised Angel Medical Center’s management team. “We had a reasonable length of stay, so we thought we had a good case management program,” smiles CEO Mike Zuliani. “What we had were great employees…without the resources they needed.”
- Case management was limited to utilization review
- No case manager was staffed on weekends
- Located apart from the patient care area, case management reported to the CFO
- Available benchmarking reports were not accessed
- For convenience, patients were often admitted the day before scheduled procedures
- Reimbursement was affected by incomplete documentation
Q Solutions
Simultaneously initiating rigorous training, data analysis and team building, QHR built a vibrant case management program.
Restructuring to create a director of case management position and locate activity adjacent to the main nursing station, QHR revised job descriptions and extended case management to weekend shifts.
Education was the program’s centerpiece; the hospital’s respected case manager received intensive training at the QHR Learning Institute. “She then educated the medical staff about the importance of documentation for accurate code assignments.”
Training wasn’t limited to nurses: QHR established a committee including the CFO,controller and representatives from the medical staff and health information systems department, along with case management.Installing and retrieving previously neglected report modules, QHR helped the group understand and use the newly mined data, including DRG benchmarking, cost per case, profit and loss comparisons to peer hospitals,and physician profiling.
The data opened the team’s eyes. “We were shocked to learn that some of our high volume product lines had small contribution margins,” comments CFO Don Wade. “There was resistance at first…but practice patterns are changing.” The team looks forward to lively discussions at the meetings and communicates its progress in a monthly newsletter; subcommittees take assignments to other departments like pharmacy and medical records. “We’ve made huge strides in one year,” adds Zuliani, “and it keeps getting better, every month.”
The Outcome
“Our case manager returned so enthused from the QHR Learning Institute – she couldn’t wait to show the doctors the reports she’d learned to use. They’re very satisfied with the new information she now offers.”
