**Presented at the 2022 CMSA Annual Conference**
*** RN and CCM credits ***
The global pandemic has created a challenge for
hospital leadership to maintain staff safety and satisfaction, provide diligent
care coordination and utilization of technology to enhance processes
efficiently. At Memorial Sloan Kettering Cancer Center- a comprehensive cancer
center, the Case Management Department was lacking processes standardization;
workflow revealed waste and redundancies; lack of documentation standardization
and compliance. There was no on-site weekend case manager coverage and an
underutilization of technology that could enhance team communication.
Furthermore, qualitative survey revealed the need for staff involvement in
change management and remote work opportunities during the pandemic. As a
result, communication lapses occurred among the medical teams, which resulted
in delays in discharge, which in turn increased hospital length of stay,
utilization costs, absenteeism and created staff burnout and dissatisfaction. The aim was to enhance staff satisfaction by
implementing Shared Governance, a hybrid work model to optimize a work-life
balance, increasing technology utilization to enhance documentation and team
communication, and implementing coverage for weekend case management to reduce
hospital length of stay, and enhance patients and families’ experience. A Case Management Council was created. The
areas of concentration included Quality Safety, Professional Development,
Evidence Based-Practice, Recruitment, Retention, and Recognition. New processes
and procedures were created to mitigate unnecessary documentation and meet CMS
regulations. An initial discharge assessment and final disposition note were
developed. The integration of systems allowed for these notes to be visible to
all disciplines. The hybrid work from
home model consisted of biweekly rotation with half of the staff in each
rotation. An onsite support system and productivity measures were instituted.
Technology support such as Teletracking, Voalte, Jabber, and the creation of an
electronic discharge home care order were created to support the hybrid model
to enhance team communication and patient throughput A weekend case manager coverage was also
added. An onsite and telephonic case manager framework facilitated discharge
planning and early discharge conversations. The provision of technological
equipment provided remote coverage for Sundays. Since changes were implemented, qualitative
and quantitative data revealed staff satisfaction and participation in
decision- making; documentation compliance increased to a rate of 100%; and the
hybrid model showed no disruption in care and patient throughput, teamwork,
staff safety or work-life balance. A post implementation staff survey revealed
the benefits of keeping the hybrid model as part of the department’s scheduling
structure. The use of technology has allowed for better team communication in
preventing discharge delays. The weekend coverage revealed the benefits of
having a CM present and has allowed staff to start early discharge planning and
complete weekend discharges. Transformational
change management starts with staff inclusion. Ensuring staff safety and
meeting the organization’s operational needs were and are still challenges in
this unprecedented time. The hybrid model demonstrated that remote work could
be beneficial for inpatient setting. Technology support such as Teletracking for
team communication, Jabber and documentation standardization have all
contributed to the success of this initiative. While the Corona virus has
changed the way healthcare workers do their jobs – whether in person or from
home – it has significantly reshaped the culture of work in healthcare.
Healthcare leaders need to explore new ways to ensure care coordination,
safety, and compliance.*** RN and CCM credits ***
OBJECTIVES:
- Describe evidence-based processes to enhance departmental operations and staff satisfaction.
- Apply different strategies to leverage technology for team communication.
- Analyze the principles of a hybrid work model.
PRESENTER:
Carmen Castillo, MSN, RN, CCM