Discharge Planning Handbook for Healthcare: Top 10 Secrets to Unlocking a New Revenue Pipeline, 1st Edition (Paperback) book cover

Discharge Planning Handbook for Healthcare

Top 10 Secrets to Unlocking a New Revenue Pipeline, 1st Edition

By Ali Birjandi, Lisa M. Bragg

Productivity Press

208 pages | 40 B/W Illus.

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pub: 2008-08-07
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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.

Table of Contents

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





Subject Categories

BISAC Subject Codes/Headings:
BUSINESS & ECONOMICS / Industries / Service Industries
MEDICAL / Administration