Case Management Case Study
The Case: Thibodaux Regional Medical Center, Thibodaux, Louisiana
The Challenges
Thibodaux Regional Medical Center was experiencing severe case management pains. The hospital’s CM department didn’t have a director. It didn’t have a physician advisor, and it didn’t have clerical support. What it did have was a CM staff that was juggling 30-plus cases per person per shift – with little, if any, time left to practice critical CM functions, including quality improvement, resource utilization and concurrent medical review.
“TRMC’s Case Management design was fl awed and, in general, there was a lack of understanding of how a strong CM department can improve things like length of stay, bed management and patient flow,” said Gina Thibodaux, the hospital’s Director of Case Management.
Q Solutions
- QHR began with an assessment of TRMC’s current case management processes. From thisassessment came an action plan – one that was based on best practices and called for:
- A restructuring of the CM department to a physician-based model
- The creation of a CM director position
- An expansion of the current CM staff, including 3 new RN CMs and a clerical support person
- The appointment of a physician advisor to work with medical staff on improved patient outcomes
- The establishment of an admissions “gatekeeper” position
The Outcome
- With QHR’s support, Thibodaux Regional Medical Center:
- Decreased its MCR length of stay from 5.56 to 4.99 – surpassing its goal of a .5 day reduction
- Maintained its Press Ganey 99th percentile for patient satisfaction
- Improved employee and physician satisfaction
- Impacted various quality initiatives, including a clinical documentation improvement program
“Our QHR team consistently provided the support we needed,” said Gina Thibodaux. “We could not have achieved our goals and successes without them, and we continue to work together to further improve the quality of care we provide our community.”
