Improving Hospital Outcomes Through Implementation of a Triad Model of Case Management

Abstract

The purpose of this scholarly project was to implement a Triad model of acute care case management. Participants in this project included nurse care managers, social workers and a utilization review specialist on an acute care medical-oncology unit. Acute care organizations are challenged to strategize operational practices for innovative ways to optimize case management services to meet and improve objectives during challenging times in healthcare. An evidence based collaborative care management model was implemented to facilitate optimization of each discipline with the aim to decrease length of stay (LOS), earlier discharge times and improved patient satisfaction. Length of stay decreased each month consecutively during the project with an overall decrease of 23.5% exceeding target. The percentage of patients discharged before noon increased during the first month of the project from 6% to 9% and decreased each consecutive month thereafter for a final reduction of 10.3% of patients discharged before noon; thus, not meeting the target goal of a 5% increase. Patient satisfaction scores related to the three discharge care questions within the “Transitions” global domain of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey increased from 46.3% to 46.8%; however, did not meet target of 2% increase. Implementation of a Triad model of case management successfully improved LOS and patient satisfaction yet did not meet the targeted goals for discharges before noon and patient satisfaction.