A Hot Topic In HealthcareRead Time: 4 minutes
Return visits are a hot topic in healthcare. Within the last few years, the Centers for Medicare and Medicaid (CMS) has implemented reimbursement penalties for facilities that have high rates of 72-hour returns. Decreasing these returns is a vital quality measure. How can hospitals improve these rates? Better case management may be the answer.
The 72-hour window
The generally accepted rule of thumb is that patients who return to the emergency department (ED) within 72 hours did not receive adequate care. This return rate is one of the quality measures hospitals are evaluated on. There are a variety of reasons why a patient may return to the ED. Understanding how to improve this quality measure is crucial.
By some reviews, almost half of all return visits are preventable. One strategy to reduce these returns is to improve case management. Case management teams are responsible for triaging in the emergency room (ER). This staff makes sure that the right patients see the right doctors at the right time. Triaging patients adequately the first time ensures that patients are receiving higher quality care.
Improving your case management team
Particularly in small hospitals, staffing a robust case management team can be challenging and costly. Many hospitals find that remote case management teams are the solution. Also called telecase management, these teams provide triage services remotely. This ensures that the ED is staffed 24/7. Remote case management also reduces strain on full-time staff members.
One factor in patients returning the ER is adequate education on health conditions. For example, if a patient presents at the ER with a viral infection, the patient should receive education on when to expect an improvement in symptoms. If the patient still has a fever in a day or so and doesn’t know if this is normal, the patient may return to the hospital, even if further treatment is not needed.
More informed patients
Improving patient education requires effort from all staff. However, many hospitals have found success from employing hospitalists. These specialists are physicians who are dedicated to caring for patients in the inpatient setting. Hospitalists serve as a clear point-of-contact for patients and families. These physicians can also improve coordination of care by ensuring that all specialists are communicating properly.
Find quality solutions
Better case management may be the solution to improving quality while keeping costs low. Remote case management helps ensure that patients are seeing the right providers. This directly decreases 72-hour return visits. Start exploring solutions today to improve case management and reduce ED returns.