Admissions and Discharge

Now that you’ve identified your top patients and admitted them, tracking performance is critical to successful outcomes, reputation, and profitability.

While you should look at many of the same metrics as mentioned in part 1 of this blog series, you look at them in a different light. You are reviewing changes in diagnosis, transfers in and out of the facility, changes in payor types, and outcomes. Your software should allow you to monitor these key data points easily and be flexible enough to work around the different workflows of patients, treatments, therapies, and physicians.

Pay close attention to the following:

  1. Physician: Being able to tie physicians to outcomes is critical to the health of patients/residents, as well as to your facility’s reputation and financial health. Do you know which doctors are providing you with the referrals that support positive outcomes and sustainable business practices? Can you tell if the physicians are responding in a timely manner? Is your software capturing changes in your workflows to ensure they’re appropriate and that they support proper treatments, therapies, and medication distribution? Are you being guided to a productive discussion with problem physicians so you can convert them to champions?
  2. Staffing: Like tracking physicians to outcomes, it’s also important to understand the success rate of your nursing staff based on their assigned patients. It can help you identify training needs, workload imbalances, positive factors, and “better next times.”
  3. Actual stay days versus expected stay: This helps determine the responsiveness for the physician and staff. Is it because you are accepting higher acuity patients, etc.? You want to have those metrics available. This becomes critical in understanding the cost of outpatient services, as a three-hour procedure that takes four to clear is a 25% increase in labor allocation. Little slips can add up to big losses over time.
  4. Ensure you have the tools to track infection, wound care, and other critical issues during their stay. Utilization management is critical to success in all specialty and general acute hospital settings.
  5. Once patients have been discharged, you need to stay aligned with your key data points to be tracking the same information as above:
    1. Discharge physician
    2. Continuing care destination
    3. Final payor
    4. Total length of stay

“As we move further into value-based care and patient-centered initiatives continue to gain importance, we need to focus on understanding our costs and profitability down to the activity level. It will be important to understand where a facility is spending money daily to better allocate resources and target revenue generation.” – Ken Miller, Senior Revenue Cycle Consultant, Cantata Health.

How long is the season?

We’ve mentioned length of stay across each of the areas of focus thus far, but now we call it out as its own area to drive performance indicators.

  1. Average versus total length of stay: Look at the average across all lines of business. Being able to drill down by therapy/procedure type by payor will help ensure the anticipated reimbursement is covering the costs.
  2. Moving into value-based care mode: Understanding of the cost mix becomes even more critical than before. The way forward is to focus on patient transparency. Before that happens, hospitals need to come to grips with their cost mix and understand the drivers on patient throughput. Knowing that patients with a particular set of comorbidities will incur a longer procedure is predictable when you analyze your historical data. Linking your chargeable and non-chargeable supply utilization to an encounter with integrated supply chain management is another piece of the puzzle.

Stay tuned to Part III of this series coming soon and know that you can always find helpful information on our Resource Center.

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