Observation Patient Trends and Management Strategies
August 14, 2011
Posted by chcablogadmin in : Financial Viability, Industry Trends, Manpower & Workforce
Operational and financial challenges exist when children’s hospitals use the “observation status” patient category. To understand observation patient trends for children entering hospitals through Emergency Departments, a group of physicians, operational leaders and CHCA staff members analyzed PHIS data from 16 CHCA hospitals. To prevent costly delays in throughput for patients entering the ED, the group offered several successful strategies. They include monitoring entry points to identify appropriate patient status early in the stay, educating staff on observation guidance (medical necessity) based on Medicaid, Milliman© and/or InterQual® criteria, developing order sets and/or pathways to avoid delays in treatment, and forming relationships with payer groups to facilitate prevention and timely resolution of denials. Learn more about the groups’ findings and additional strategies. If you have questions, please contact Carla Hronek (carla.hronek@chca.com or 913-981-4165).
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