Identify that Resource
Partner with these multidisciplinary team members to facilitate discharge education.
Who are the Bedside Nurse and/or Therapist?
It's crucial to identify these cases early and bring them to special meetings for collaborative planning.
What are complex cases?
You can escalate predicted problems to them for troubleshooting or to assist with barriers.
Who is Leadership?
PACNN & CSH Owned/Affiliated providers are expected to be more willing to accept these kinds of patients compared to providers outside the network.
What are challenging and complex patients?
Involve this team member to facilitate peer to peer discussions with the attending regarding complex cases.
Who is your Physician Advisor?
Referring to these specific providers is a proven tactic for achieving these two beneficial outcomes in acute care.
What are decreasing acute LOS and preventing readmissions?
Collaborate with these post-acute care facilities/agencies on complex or challenging patients.
What are the PACCN and CSH Owned/Affiliated Facilities?
Building relationships, understanding facility capabilities and reasons for denials, open communication, and appropriate escalation are all strategies to achieve this.
What is PAC acceptance of challenging and complex patients.
Collaborate with these team members if you encounter a situation or case that you are unsure how to approach.
Who are your Care Coordination team members?
The assigned DRG for your patient's case is 313 Chest Pain with a GMLOS of 1.7 days but today is LOS day 3 & you notice that the physician documented "acute myocardial infarction." You reach out to this team to discuss the discrepancy.
What is CDI?