COST CONTAINMENT

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COST CONTAINMENT
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Outcome Management

• Karen Niner RN BSN
• Manager
• Outcome Management department

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Cost Containment

• Watch for Avoidable Delays.
• Write discharge orders 24hrs prior to planned
  D/C.
• Involve social work services early.
• Move to correct level of care when criteria
  changes.
• Business rounds helpful.
• Need D/C orders early Friday for W/E DCs to
  precert before the W/E

• Residents and MDs
• Pay attention to correct inpatient orders
• Admit as Observation
• Admit as Inpatient
• NO SOCIAL ADMISSIONS ALLOWED!
• D/C if OK w/ PT/OT only works if going homeNot
  needed for ECF.

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How Outcome Management can help

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Outcome Management

• Consists of Bachelors prepared Registered Nurses
  called Resource Utilization Coordinators (RUCs)

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Outcome Management

• Licensed Social Workers and
• Social Work Assistants

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RUCs role

• REVIEW CHARTS
• Appropriate Inpatient orders (OBV vs IA)
• Appropriate use of resources
• Monitor and report Avoidable Delays (AVDs)
• Report to SW/SWA any potential discharge needs
• Monitor Readmissions

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Collaborate with Licensed Social Workers and
Social Work Assistants

• Screening and Assessments for D/C needs Discharge
  Planning
• Crisis Intervention
• D/C Resource Experts

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Collaborate with many departments
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OBV graph
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Hospital Acquired Conditions

• Complete the History and Physicals
• Remember to document what is present on
  admission
• UTI
• Skin breakdown
• pneumonia
• Etc.

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Patient Communication

• Patient Satisfaction relies on good communication
  between you and
• the patient their families
• the patients nurse
• OTM
• GOOD PATIENT CARE BEGINS WITH YOU!

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ATTENTION TO ALL PHYSICIANS!!!!

• ADMIT ORDERS MEDICARE COMPLIANCE
• Admission Orders need to be specific for STATUS
  of INPATIENT or OBSERVATION
• Appropriate Status Order
• ADMIT AS INPATIENT
• ADMIT AS OBSERVATION
• Inappropriate Status Order
• ADMIT TO floor________
• ADMIT TO Dr. ____________

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