1st Edition

Discharge Planning Handbook for Healthcare Top 10 Secrets to Unlocking a New Revenue Pipeline

By Ali Birjandi, Lisa M. Bragg Copyright 2008
    206 Pages 40 B/W Illustrations
    by Productivity Press

    206 Pages
    by Productivity Press

    Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. The Discharge Planning Handbook for Healthcare: Top Ten Secrets to Unlocking a New Revenue Pipeline provides innovative new solutions that will show hospital administrators how to turn one of the most antiquated aspects of healthcare into one of the most productive. The performance-improvement concepts and approaches discussed in this volume balance all aspects of existing business models and provide a new approach to managing the discharge planning process.

    Management engineer and Six Sigma Black Belt Ali Birjandi and registered nurse and administrative director Lisa M. Bragg employ innovative solutions to help readers:

    • Redefine the concept of discharge planning
    • Assign the proper metrics
    • The COS-Q snapshot – a new tool for success
    • Employ Lean concepts in redesign
    • Apply a practical approach to improvement
    • Create a culture that produces results

    An extended case study invites managers and administrators to take an interactive approach to the learning and applying of these concepts. A spreadsheet tool is included to help readers stay on task in their quest to improve efficiency and quality of care. The approach and methods taught in this book have led to dramatic results in a number of institutions. When adopted by your organization, they can help to improve performance and boost revenue.

    Discharge Planning Defined
    Discharge Planning Defined
    Key Stakeholders
    Team Members of the Discharge Planning Department
    Discharge Planning Models
    COS-Q: The Most Important Letters in Optimizing Discharge Planning
    Impacts of Discharge Planning on COS-Q
    The Future State of Discharge Planning
    How Optimized Is Your Current Model?
    Key Elements of an Optimized Discharge Planning Department
    Standardized Tools
    Efficient Process Flow
    Technology Utilization
    Efficient Communication Systems
    Proactive vs. Reactive Organizations
    Business Intelligence
    Labor Productivity
    Quality Metrics
    Financial Performance
    Customer Service
    Maximized vs. Optimized
    New Metrics for Success
    Expanded Metrics
    Inflow/Admission Data
    Length-of-Stay Data
    Variance Data
    Medical-Necessity Data
    Discharge Data
    Denial-and-Appeal Data
    Readmit Data
    Customer Service Data
    Referral Data
    Quality Data
    Uncovering the Data Story
    Inflow/Outflow Assessment
    Step 1: Discharge Data
    Step 2: Admission Data
    Step 3: The Relationship of the Admit and Discharge Data
    Step 4: Look at Other Related Data
    Throughput Management Assessment
    Step 1: Length-of-Stay Data
    Step 2: Relationship between Day of Admission and Length-of-Stay Data
    Step 3: Average Length of Stay for Patients Requiring Post-Acute Care
    Step 4: Bed Turnover Rate
    Step 5: Variance Data
    Step 6: Percentage of Days Meeting Medical Necessity/ Not Meeting Medical Necessity
    Step 7: Concurrent Denial Rates
    Step 8: Observation Conversion Rate Data
    Step 9: Observation > Hours
    Step 10: Days-Saved Data
    Discharge Data Assessment
    Step 1: Discharge Trends
    Step 2: Average Length of Discharge
    Step 3: Discharge Delay Reasons
    Step 4: Cancelled Discharges
    Utilization Review Assessment
    Step 1: Percentage of Cases Denied for Medical Necessity
    Step 2: Average Dollars per Denied Case
    Step 3: Percentage of Cases Overturned
    Discharge Planning Outcomes Assessment
    Step 1: Readmit Rate/Reason
    Step 2: Referral Tracking
    Quality Assessment
    Core Measures
    Customer Service Assessment
    Customer Service Survey
    Discharge Planning Team: COS-Q Snapshot
    Lean Concepts for Discharge Planning
    Overview of Lean Concepts
    The Seven Wastes
    Popular Lean Tools
    Value Stream Mapping
    S Methodology
    Spaghetti Diagram
    Visual Workplace
    The House of Lean
    The Top  Secrets to a New Revenue Pipeline
    Secret 1: Less is More
    Secret 2: Put “Aces” in Their Places
    Secret 3: Learn the Language of the Payer
    Secret 4: Understand Medicare Observation Status
    Secret 5: Attack Variance Days
    Secret 6: Capture the Flag
    Secret 7: Learn to Tell Your Story
    Secret 8: The -Hour Drill
    Secret 9: Know the Code
    Secret 10: Be Aggressive (Proactive Denial Management)
    The Results-Oriented Job Description
    Why Job Descriptions Matter
    Job Description vs. Job Function vs. Job Focus
    Preparing a Results-Oriented Job Description
    Interactive Discharge Planning
    Reactive To Proactive
    Proactive to Interactive
    Empowered to Perform: Being Interactive
    Leadership Support
    Tipping toward Technology
    Resistance to Change
    Change Matrix
    Automation: The Cornerstone of Process Reengineering
    Gap Analysis
    Technology Vendor Selection Process
    Six Sigma Simplified
    The DMAIC Model
    The Pillars of Six Sigma
    Statistical Tools
    The Lean–Six Sigma Action Workout: Speed, Simplicity, and Strength
    Creating a Culture of Accountability
    Identifying Lost Accountability
    What is Accountability?
    Gaining Systems Accountability
    Gaining a Culture of Team Accountability
    Maintaining Accountability
    The Final Steps to Success
    The Next Steps to Success
    Maintain the Gain
    Case Study: Reshaping Care Delivery at Hospital “A”
    Assessment and Findings
    Strategic Challenge
    The Key


    Ali Birjandi