Improved Case Management Processes Aid in Patient Care and Recovery

A focus on improving case management processes at Southern California Hospital at Culver City has created a more efficient, streamlined system that benefits both patients and hospital. The improved process means hospital resources are not overutilized and patients can go home sooner.

“It has been a great initiative that has helped patients receive more efficient care so they can get back to their families and homes faster,” Paguio said.

The changes included hiring additional staff members, bringing on a physician advisor, and implementing a rigorous training program.

“We really overhauled the entire department,” said Arlene Paguio, case management director. “By increasing the number of people on staff, we decreased each case manager’s individual workload, which increases the quality of care for our patients. We also re-trained all staff members to the national standards for case management.”

Better Than National Average

The new approaches to boost teamwork, accountability, and communication have paid off. The average length of stay for patients—a measure of hospital efficiency—has improved from seven days in 2017 to 4.25 days in 2019. This reduction of almost three days places Southern California Hospital at Culver City better than the national average.

While doctors and nurses are frequently recognized for their efforts in patient care, case managers remain the unsung heroes of the health system. Case management, at its most basic level, involves the assessment of a patient’s needs and the organization of available services and resources to fulfill those needs. It requires planning, coordination, negotiation, and advocacy at the highest levels.

Hospital case managers, in particular, have the responsibility of making sure that patients are discharged home within a safe amount of time. The more days that patients unnecessarily spend in the hospital, the greater their risk for a hospital-acquired infection. Also, it means less beds are available for incoming patients.

Setting Expectations

“Our case managers are licensed nurses with a clinical background, and their job is to meet personally with all patients within 48 hours of admission,” Paguio explained. “They set an expectation for how long each patient will be here.”

Paguio began by hiring more registered nurses to act as case managers. Next, all staff members—both new and veteran—received updated training that reflects the current practice of healthcare delivery system case management and transitions of care.

Efforts to improve communication included a daily departmental meeting where all ongoing cases are discussed in detail. The hospital also hired a physician advisor who comes twice a week to serve as an expert to help expedite patient care, reduce unnecessary medication use, and facilitate outpatient follow-up arrangements.

"We stay focused on monitoring the duration of their stay with us from the time of admission up to discharge whether it is to home with their family, another hospital, or to a nursing home.” said Paguio.

All in all, the new streamlined case management system helps Southern California Hospital at Culver City deliver high-quality patient care more efficiently and within in a safer environment.

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