Archive for October, 2008
CMW Tip of the Week: HIM can help you de-code data
This week’s tip comes from Harriet Kinney, RHIT, CHC, organizational integrity manager for Trinity Health in Novi, MI.
Case managers should team up with their health information management (HIM) department when looking at data. There’s usually somebody in HIM, such as the HIM director or a sharp analyst, who can help talk case managers through what they’re looking for. This can be especially useful when it comes to getting data for all pneumonia cases, for example.
The way a nurse may think of a pneumonia case is not necessarily how the bill went out the door, because of the DRG. A nurse case manager may think, “Well, Mr. Smith had pneumonia” but actually pneumonia was one of the many secondary conditions that were being treated. After careful study it is revealed that pneumonia was not the reason Mr. Smith was admitted to the hospital. He was admitted because he had a myocardial infarction (MI). The bill goes out saying his principal diagnosis was an MI, and the pneumonia code is listed somewhere down in secondary diagnoses.
Therefore, speaking with somebody in HIM will help case managers understand how claims go out or how the data from coding goes out.
Have a tip or tool you’d like to share? Or maybe a question for our experts? E-mail it to editor Julie McGinley at jmcginley@hcpro.com.Your thoughts could be featured in the next issue of Case Management Weekly!
CMW Tip of the Week: Talk with patients to determine outcome goals
This week’s tip, an “Ask the Expert,” comes from Karen Zander, RN, MS, CMAC, FAAN.
Q: We social worker and nurse case managers have caseloads that are too big and we don’t know when to discharge patients from the practice. How long should patients be followed?
A: There is a point at which the best interventions either work or don’t work for a particular patient. That point should be preset and constantly discussed between the disease manager and the patient. Ask questions such as, “How will we both know when you feel like the master of your disability/disease/condition?” Making the outcomes (patient goals) measurable and writing them down at the beginning is the best way to keep them in focus. Patient goals should be evaluated regularly.
Have a tip you’d like to share? Or maybe a question for our experts? Email it to editor Julie McGinley at jmcginley@hcpro.com.Your thoughts could be featured in the next issue of Case Management Weekly!
