1st Edition
Discharge Planning Handbook for Healthcare Top 10 Secrets to Unlocking a New Revenue Pipeline
Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. The Discharge Planning Handbook for Healthcare: Top Ten Secrets to Unlocking a New Revenue Pipeline provides innovative new solutions that will show hospital administrators how to turn one of the most antiquated aspects of healthcare into one of the most productive. The performance-improvement concepts and approaches discussed in this volume balance all aspects of existing business models and provide a new approach to managing the discharge planning process.
Management engineer and Six Sigma Black Belt Ali Birjandi and registered nurse and administrative director Lisa M. Bragg employ innovative solutions to help readers:
- Redefine the concept of discharge planning
- Assign the proper metrics
- The COS-Q snapshot – a new tool for success
- Employ Lean concepts in redesign
- Apply a practical approach to improvement
- Create a culture that produces results
An extended case study invites managers and administrators to take an interactive approach to the learning and applying of these concepts. A spreadsheet tool is included to help readers stay on task in their quest to improve efficiency and quality of care. The approach and methods taught in this book have led to dramatic results in a number of institutions. When adopted by your organization, they can help to improve performance and boost revenue.
Discharge Planning Defined
Key Stakeholders
Team Members of the Discharge Planning Department
Discharge Planning Models
COS-Q: The Most Important Letters in Optimizing Discharge Planning
Impacts of Discharge Planning on COS-Q
The Future State of Discharge Planning
References
How Optimized Is Your Current Model?
Key Elements of an Optimized Discharge Planning Department
Standardized Tools
Efficient Process Flow
Technology Utilization
Efficient Communication Systems
Proactive vs. Reactive Organizations
Transparency
Accountability
Business Intelligence
Labor Productivity
Quality Metrics
Financial Performance
Customer Service
Benchmarking
Maximized vs. Optimized
New Metrics for Success
Expanded Metrics
Inflow/Admission Data
Length-of-Stay Data
Variance Data
Medical-Necessity Data
Discharge Data
Denial-and-Appeal Data
Readmit Data
Customer Service Data
Referral Data
Quality Data
References
Uncovering the Data Story
Inflow/Outflow Assessment
Step 1: Discharge Data
Step 2: Admission Data
Step 3: The Relationship of the Admit and Discharge Data
Step 4: Look at Other Related Data
Throughput Management Assessment
Step 1: Length-of-Stay Data
Step 2: Relationship between Day of Admission and Length-of-Stay Data
Step 3: Average Length of Stay for Patients Requiring Post-Acute Care
Step 4: Bed Turnover Rate
Step 5: Variance Data
Step 6: Percentage of Days Meeting Medical Necessity/ Not Meeting Medical Necessity
Step 7: Concurrent Denial Rates
Step 8: Observation Conversion Rate Data
Step 9: Observation > Hours
Step 10: Days-Saved Data
Discharge Data Assessment
Step 1: Discharge Trends
Step 2: Average Length of Discharge
Step 3: Discharge Delay Reasons
Step 4: Cancelled Discharges
Utilization Review Assessment
Step 1: Percentage of Cases Denied for Medical Necessity
Step 2: Average Dollars per Denied Case
Step 3: Percentage of Cases Overturned
Discharge Planning Outcomes Assessment
Step 1: Readmit Rate/Reason
Step 2: Referral Tracking
Quality Assessment
Core Measures
Customer Service Assessment
Customer Service Survey
Discharge Planning Team: COS-Q Snapshot
References
Lean Concepts for Discharge Planning
Overview of Lean Concepts
The Seven Wastes
Popular Lean Tools
Poka-Yoke
Value Stream Mapping
S Methodology
Spaghetti Diagram
Visual Workplace
Kanban
The House of Lean
The Top Secrets to a New Revenue Pipeline
Secret 1: Less is More
Secret 2: Put “Aces” in Their Places
Secret 3: Learn the Language of the Payer
Secret 4: Understand Medicare Observation Status
Secret 5: Attack Variance Days
Secret 6: Capture the Flag
Secret 7: Learn to Tell Your Story
Secret 8: The -Hour Drill
Secret 9: Know the Code
Secret 10: Be Aggressive (Proactive Denial Management)
Conclusion
The Results-Oriented Job Description
Why Job Descriptions Matter
Job Description vs. Job Function vs. Job Focus
Preparing a Results-Oriented Job Description
Interactive Discharge Planning
Reactive To Proactive
Proactive to Interactive
Empowered to Perform: Being Interactive
Leadership Support
References
Tipping toward Technology
Resistance to Change
Change Matrix
Automation: The Cornerstone of Process Reengineering
Gap Analysis
Technology Vendor Selection Process
Six Sigma Simplified
The DMAIC Model
The Pillars of Six Sigma
Statistical Tools
The Lean–Six Sigma Action Workout: Speed, Simplicity, and Strength
Creating a Culture of Accountability
Identifying Lost Accountability
What is Accountability?
Gaining Systems Accountability
Gaining a Culture of Team Accountability
Maintaining Accountability
References
The Final Steps to Success
The Next Steps to Success
Maintain the Gain
Case Study: Reshaping Care Delivery at Hospital “A”
Background
Assessment and Findings
Strategic Challenge
The Key
Acronyms
Bibliography
Index
Authors
Biography
Ali Birjandi