News and Events
Case Management Role Expands to Improve Quality and Efficiency
Case Management has always played an important role in
coordinating the patient care process, but recently Lima Memorial's
Case Management Department has begun to expand their services to
become fully integrated with all stages of patient care.
According to Judy Recker, administrative director of quality,
all of their efforts are focused on strengthening the quality and
efficiency of Lima Memorial's approach to patient care. "We are
very excited about our new model because it is designed to involve
case management throughout the entire continuum of care, including
after discharge," said Recker.
The new case management model has several goals, including
improving core measures, decreasing avoidable readmissions and
improving resource utilization. In addition, Case Management is
focusing on improving clinical documentation to prevent Recovery
Audit Contractor (RAC) Program denials and to accurately reflect
the acuity of the patients.
Under the new model, case management coverage has been expanded
to the Emergency Center. These additional case managers will work
with the Emergency Center team to assess patients quickly and
determine if they qualify for inpatient admission or need
observation services before they are placed in a bed. They also
proactively identify the needs of patients discharged from the
The new case management model is consistent with the Health Care
Reform Law's emphasis on decreasing the overall cost of health care
by improving efficiency and coordination. "The health care industry
is changing, and the case management team is please to be able to
play a key role in helping advance how we care for patients while
navigating through these changes," said Recker.