Mar

10

Tip: Evaluate your facility’s UR committee

By Case Management Weekly

A fundamental component of a case management service and the hospital at large is the active presence of a utilization review (UR) committee as part of the medical peer review and governance infrastructure. How do you know if your UR committee is effective?

Here are some signs of a dysfunctional UR committee:

• Members are bored and don't come, or if they do come, they don't contribute
• The meeting keeps getting cancelled
• The minutes have the same agenda every month
• No data gets reviewed and there are no actionable items
• No responsibilities are delegated and/or there is no follow-through on delegated items

Here are some signs of a functional UR committee:

• Meetings occur at least quarterly and minutes are taken
• Most of the members attend most of the time, including the physician members
• The UR committee is connected formally to other physician committees as well as hospital committees such as ethics, quality improvement, and patient satisfaction
• The UR committee has up-to-date data that is trended and displayed in user-friendly ways
• The UR committee evolves its title to the case management committee, the clinical resource management committee, the clinical integration committee, etc.