CMSA Today - Issue 6, 2016 - 23

solving, positively affected the long-LOS patient population. Improving Revenue: Partnering with the revenue cycle staff to implement a Denials Management Team to identify and resolve root causes of clinical denials and write-offs positively impacted the hospital's bottom line. Breaking Down Silos: Working with human resources to create new job descriptions, roles, and responsibilities for case managers, clinical social workers and department leadership helped to break down silos, as did decentralizing the case management team work space to increase visibility and availability to physicians, nursing staff, patients and families. "Transforming care delivery at McLaren Macomb truly was the result of all of these initiatives," said Dr. Patricia Hines, managing director of Novia Strategies and Care Management Transformation practice lead. "This collaborative approach broke down silos, created a groundswell of positivity, and resulted in a highly engaged workforce focused on progressing patients safely and efficiently through the system." The key to this rapid-cycle redesign was that the McLaren team members, not the consultant, vetted industry-leading case management models and tailored the plan they chose to best fit their local needs. The internal cultural change required among all participating departments was significant, but because the buy-in and trust in these new protocols and processes was born from within, among teams of nurses, social workers, physician advisors, and leadership, it was successful. "After 10 months of hard work, we have forged a new foundation," notes COO Candela. "Our previous methods would not have allowed these changes to take root and improve our case management delivery model." thE RESULtS With the goals of reducing excess days and cost per case, modernizing the case management department, improving interdisciplinary communication related to patient care progression, applying best practices to guide medical care and reducing clinical denials and write-offs, McLaren Macomb's new approach led to significant and sustainable successes. Specifically, they decreased LOS by 16 percent, decreased excess days by 21 percent and improved quality of patient care. Because of the hospital's commitment to sustained improvement and consistent focus on the key project metrics, Novia was able to deliver an overall reduction in the LOS of outlier patients by 0.4 days over the fourmonth implementation period. Incorporation of Rapid Discharge Huddles into the daily routine on each nursing unit resulted in more complete engagement of front-line nurses, who reported an increased understanding of the discharge plan as well as a stronger relationship with their case managers. Novia created dashboards to provide sustained visibility into both process and outcome metrics associated with the newly established care coordination processes; as a result, individual nursing units were armed with information that enabled them to continually evaluate and improve their teamwork. Physician engagement in the care redesign efforts for chest pain patients resulted in streamlined order sets and an algorithm to guide the selection of specific cardiac diagnostic studies. Novia provided data specific to individual physicians which demonstrated where practice variation existed and armed the medical staff leaders with information to coach and support their staff. As a result of these efforts and the establishment of a dedicated Clinical Decision Unit, the hospital's observation LOS decreased. Novia also optimized McLaren's revenue cycle processes by working with finance leadership to create new monitoring tools, clarifying roles and responsibilities, improving charge capture, increasing collections, and reducing recurring errors. For the postimplementation monitoring period, results showed a 44 percent decrease in clinical write-offs and an improved pre-authorization process that decreased OR cancellations. "Novia's data-driven approach and ability to connect previously isolated departments improved patient service as well as the hospital's bottom line," said Theresa Brandon, managing director of Novia Strategies and Revenue Cycle practice lead. FiNaL thoUghtS every transition yields new knowledge. McLaren's culture and case management evolution in 2015 was no exception. Because the hospital was willing to acknowledge the need for expert support from an outside source familiar with industry best practices and because that partner, Novia, pursued a strategy of embedding its consultants in the hospital environment long enough to learn the individual and market challenges, the results were exceptional. establishing a successful case management model requires buy-in and acceptance of many departments, the willingness from within each of those departments and among all impacted professionals to change the status quo, a collapse of silos and the institution of intragroup connectivity and, finally, a common goal of making each patient experience the best it can be. ■ Nancy Magee, MSN, is senior consultant at Novia Strategies, Inc. Issue 6 * 2016 CMSA TODAY 23

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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