CMSA Today - Issue 6, 2016 - 21

Care Coordination Breaking Down Silos & Strengthening Hospital Care Coordination BY NANCY MAGEE, MSN I n this day and age, the success of any given hospital relies on its ability to build strong interdisciplinary teams willing to communicate and coordinate in order to provide patients with the most effective care experience and the highest-quality outcome. We all realize that is much easier said than done. But, what if hospital administrators, physicians, nurses, and other professional and support services made the effort to partner with the hospital's case management team to alter the status quo to which so many hospitals have become accustomed? To break down silos and change culture and climate, to overhaul protocols and processes in care coordination, and, as a result, strengthen patient care coordination for the patient? In 2015, McLaren Macomb Hospital in Mount Clemens, Michigan, did exactly that. THE CHALLENGE McLaren Macomb, a 288-bed acute care hospital, is home to more than 2,000 employees and 420 affiliated physicians serving a community of over 100,000 residents. McLaren provides a full range of services including oncology and cardiovascular care, and operates one of the busiest emergency departments in its area. In 2015, the hospital faced significant challenges with bed capacity, but it knew that to address the capacity issue would ensure an efficient, productive and sustainable healthcare environment. McLaren administrators and case management leadership identified the need to create greater capacity by reducing length of stay, improving throughput, and efficiently aligning resources with the needs of patients and families. McLaren had previously tried to institute these changes and failed. "We knew we needed to improve how we delivered case management at our facility. Previous attempts by multiple leaders had failed to make substantial change and improve outcomes. It became clear that we needed a new model and subject matter experts from outside the organization to bring us industry best practices," said McLaren Macomb's chief operating officer, Chris Candela. That's when the hospital decided to enlist the help of Novia Strategies, Inc., a national healthcare consulting firm specializing in care management, among other disciplines. NOVIA'S ASSESSMENT What was unique about Novia's approach to assessing McLaren's challenges was its grassroots engagement with the hospital case management team. Consultants embedded with administrators, managers, clinicians, and social workers for months-on the floors, in patient rooms, in department meetings and discharge discussions-to yield an honest assessment of the hospital's obstacles to care progression and efficient transitional planning. They discovered the following: * P  atients whose LOS was greater than expected had an average variance of 2.6 days above the GMLOS, resulting in 1,155 excess days per month on average; * O verall LOS for DRG payers was not significantly above the GMLOS; * The primary source of clinical denials traced back to the case management functions of pre-authorization, continued stay authorization, and accurate assignment of patient status; * and, the case management and nursing departments operated in silos, resulting in significant duplication of work effort and gaps in communication as patients were prepared for discharge. Certainly, these are not uncommon problems and are faced by virtually every hospital in the U.S. to one degree or another. To build a sustainable change in culture, McLaren would need to engage with and gain buy-in from a multitude of departments and stakeholders. Novia outlined a strategic approach to building buy-in and altering a hospital's Issue 6 * 2016 CMSA TODAY 21

Table of Contents for the Digital Edition of CMSA Today - Issue 6, 2016

Patient-Centered Care
Association News
CMSA Corpo rate Partners
On Living Well: The Life-Transforming Power of Palliative Care
Improving Medications Access for Bone Marrow Transplant Patients
Breaking Down Silos & Strengthening Hospital Care Coordination
Cultivating the Art and Science of Compassionate Care
Index of Advertisers
CMSA Today - Issue 6, 2016 - cover1
CMSA Today - Issue 6, 2016 - cover2
CMSA Today - Issue 6, 2016 - 3
CMSA Today - Issue 6, 2016 - 4
CMSA Today - Issue 6, 2016 - 5
CMSA Today - Issue 6, 2016 - Patient-Centered Care
CMSA Today - Issue 6, 2016 - 7
CMSA Today - Issue 6, 2016 - Association News
CMSA Today - Issue 6, 2016 - 9
CMSA Today - Issue 6, 2016 - 10
CMSA Today - Issue 6, 2016 - CMSA Corpo rate Partners
CMSA Today - Issue 6, 2016 - On Living Well: The Life-Transforming Power of Palliative Care
CMSA Today - Issue 6, 2016 - 13
CMSA Today - Issue 6, 2016 - 14
CMSA Today - Issue 6, 2016 - 15
CMSA Today - Issue 6, 2016 - 16
CMSA Today - Issue 6, 2016 - 17
CMSA Today - Issue 6, 2016 - Improving Medications Access for Bone Marrow Transplant Patients
CMSA Today - Issue 6, 2016 - 19
CMSA Today - Issue 6, 2016 - 20
CMSA Today - Issue 6, 2016 - Breaking Down Silos & Strengthening Hospital Care Coordination
CMSA Today - Issue 6, 2016 - 22
CMSA Today - Issue 6, 2016 - 23
CMSA Today - Issue 6, 2016 - Cultivating the Art and Science of Compassionate Care
CMSA Today - Issue 6, 2016 - 25
CMSA Today - Issue 6, 2016 - Index of Advertisers
CMSA Today - Issue 6, 2016 - cover3
CMSA Today - Issue 6, 2016 - cover4
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