Discharge Planning Handbook for Healthcare

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ISBN: 9781563273926 | 1563273926
Cover: Paperback
Copyright: 8/7/2008

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Â Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. Based on 25 years of experience, Birjandi and Bragg show hospital administrators and directors how they can tap into new revenue using the Six Sigma DMAIC model (Define, Measure, Analyze, Improve, and Control). The book's step-by-step implementation strategy highlights five concepts: redefining the whole idea of discharge planning, focusing on the right metrics, augmenting re-design with lean concepts, applying a practical approach to improvement, and creating a results-oriented culture. The book includes a comprehensive case study, as well as a spreadsheet that can be used to track success.

Preface	p. xiii
Acknowledgment	p. xv
Introduction	p. xvii
Discharge Planning Defined	p. 1
Discharge Planning Defined	p. 1
Key Stakeholders	p. 2
Team Members of the Discharge Planning Department	p. 3
Discharge Planning Models	p. 6
COS-Q: The Most Important Letters in Optimizing Discharge Planning	p. 8
Impacts of Discharge Planning on COS-Q	p. 9
The Future State of Discharge Planning	p. 11
References	p. 12
How Optimized Is Your Current Model?	p. 13
Key Elements of an Optimized Discharge Planning Department	p. 14
Standardized Tools	p. 14
Efficient Process Flow	p. 15
Technology Utilization	p. 17
Efficient Communication Systems	p. 18
Interactive vs. Reactive Organizations	p. 19
Transparency	p. 19
Accountability	p. 20
Business Intelligence	p. 20
Labor Productivity	p. 22
Quality Metrics	p. 24
Financial Performance	p. 25
Customer Service	p. 26
Benchmarking	p. 26
Maximized vs. Optimized	p. 28
New Metrics for Success	p. 29
Expanded Metrics	p. 31
Inflow/Admission Data	p. 31
Length-of-Stay Data	p. 31
Variance Data	p. 31
Medical-Necessity Data	p. 31
Discharge Data	p. 35
Denial-and-Appeal Data	p. 35
Readmit Data	p. 35
Customer Service Data	p. 39
Referral Data	p. 40
Quality Data	p. 41
References	p. 48
Uncovering the Data Story	p. 49
Inflow/Outflow Assessment	p. 50
Discharge Data	p. 50
Admission Data	p. 50
The Relationship of the Admit and Discharge Data	p. 51
Look at Other Related Data	p. 51
Throughput Management Assessment	p. 52
Length-of-Stay Data	p. 52
Relationship between Day of Admission and Length-of-Stay Data	p. 52
Average Length of Stay for Patients Requiring Post-Acute Care	p. 53
Bed Turnover Rate	p. 53
Variance Data	p. 54
Percentage of Days Meeting Medical Necessity/Not Meeting Medical Necessity	p. 56
Concurrent Denial Rates	p. 56
Observation Conversion Rate Data	p. 57
Observation >24 Hours	p. 57
Days-Saved Data	p. 58
Discharge Data Assessment	p. 58
Discharge Trends	p. 58
Average Length of Discharge	p. 59
Discharge Delay Reasons	p. 60
Cancelled Discharges	p. 60
Utilization Review Assessment	p. 61
Percentage of Cases Denied for Medical Necessity	p. 61
Average Dollars per Denied Case	p. 61
Percentage of Cases Overturned	p. 62
Discharge Planning Outcomes Assessment	p. 63
Readmit Rate/Reason	p. 63
Referral Tracking	p. 63
Quality Assessment	p. 64
Core Measures	p. 64
Customer Service Assessment	p. 66
Customer Service Survey	p. 66
Discharge Planning Team: COS-Q Snapshot	p. 66
References	p. 67
Lean Concepts for Discharge Planning	p. 69
Overview of Lean Concepts	p. 70
The Seven Wastes	p. 71
Popular Lean Tools	p. 75
Poka-Yoke	p. 75
Value Stream Mapping	p. 76
5S Methodology	p. 77
Spaghetti Diagram	p. 79
Visual Workplace	p. 79
Kanban	p. 80
The House of Lean	p. 81
The Top 10 Secrets to a New Revenue Pipeline	p. 83
Less Is More	p. 83
Put "Aces" in Their Places	p. 85
Learn the Language of the Payer	p. 86
Understand Medicare Observation Status	p. 87
Attack Variance Days	p. 89
Capture the Flag	p. 90
Learn to Tell Your Story	p. 91
The 48-Hour Drill	p. 93
Know the Code	p. 95
Be Aggressive (Proactive Denial Management)	p. 96
Conclusion	p. 98
The Results-Oriented Job Description	p. 99
Why Job Descriptions Matter	p. 99
Job Description vs. Job Function vs. Job Focus	p. 101
Preparing a Results-Oriented Job Description	p. 101
Interactive Discharge Planning	p. 107
Reactive to Proactive	p. 108
Proactive to Interactive	p. 108
Empowered to Perform: Being Interactive	p. 110
Leadership Support	p. 111
References	p. 112
Tipping toward Technology	p. 115
Resistance to Change	p. 116
Change Matrix	p. 117
Automation: The Cornerstone of Process Reengineering	p. 118
Gap Analysis	p. 120
Technology Vendor Selection Process	p. 121
Six Sigma Simplified	p. 125
The DMAIC Model	p. 127
The Pillars of Six Sigma	p. 129
Statistical Tools	p. 131
The Lean-Six Sigma Action Workout: Speed, Simplicity, and Strength	p. 133
Creating a Culture of Accountability	p. 139
Identifying Lost Accountability	p. 140
What Is Accountability?	p. 141
Gaining Systems Accountability	p. 143
Gaining a Culture of Team Accountability	p. 143
Maintaining Accountability	p. 144
References	p. 146
The Final Steps to Success	p. 147
The Next Steps to Success	p. 148
Maintain the Gain	p. 151
Case Study: Reshaping Care Delivery at Hospital "A"	p. 153
Background	p. 153
Assessment and Findings	p. 154
Strategic Challenge	p. 156
The Key	p. 157
Acronyms	p. 163
Bibliography	p. 167
Index	p. 171
Authors	p. 185
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Discharge Planning Handbook for Healthcare

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