Designing and executing a clinical resource management program is not easy. It’s not so much that any one part of the program is difficult to design and implement. Rather, it’s the combination of all the parts that becomes untenable.
When we started this newsletter back in 1994, we reported the difficulties in obtaining information about payer denials. Hospitals simply could not provide actionable information to identify the source of their denials...
When case management was introduced in hospitals in the mid 80s, it was accompanied by a promise to control costs at the bedside.
A study done at the University of Kansas provides some fascinating data on bedside visits by doctors. For more than a year, researchers at the teaching hospital timed one neurosurgeon as he met with 120 patients while on rounds. The doctor was randomly assigned to sit or stand during patient visits and the patients were interviewed after the doctor left the room.
Patients described the visit as significantly longer in cases when the surgeon sat and nearly all gave a favorable report describing the visit by commenting on how the doctor sat attentively to listen. Fewer were as happy when the doctor stood.
But what did seem odd was just how long patients perceived the physician's visit lasted. On average, the patients estimated the doctor stayed for nearly 4 minutes despite the fact that the average standing visit lasted 88 seconds. When the surgeon sat, visits were actually shorter (1 min, 4 secs) but seemed longer to patients.
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The July issue of CRM UPDATE features an article about transitions of care which was a hot topic at both the 2010 CMSA conference as well as the HFMA conference. Read it now!

The Leader's Guide to Hospital Case Management
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