Specializing. Hitting the highlights.

In January 1993, The New York Hospital Medical Center of Queens, a 487 bed acute care teaching hospital, created a Case Management Department to provide quality health care for patients that was cost efficient and at the same time reduce length of stay. Registered nurses with extensive medical and surgical expertise who were quality assurance/utilization coordinators and discharge planning nurses were cross-educated to become patient case managers. The case manager coordinates patients care services to improve the quality of the total patient experience. Reviews are conducted daily. The case managers indicate quality issues on their computer worksheets. Quality concerns are addressed and referrals made to the QA Department. Case Management Team rounds are conducted on the patient unit to discuss quality issues and barriers to discharge. Many delays were noted in patient care services i.e. Physical Therapy (P.T.) and Radiology. Readmissions within 48 hours of discharge were noted and reviewed as an indicator to monitor outcome and quality concerns. Continuous Quality Improvement (CQI) projects were initiated to reduce patient care delays. Multidisciplinary teams were formed to expedite solutions. The number of P.T. and Radiology delays were dramatically reduced through the CQI process. The case manager's role is vital to the delivery of quality patient care and containment of ever spiraling health care costs.

Hospital Bed Capacity, 300 to 499↗

PubMed1994

Administrative support team. A structural innovation.

In response to societal, organization, and leadership changes, an innovative nursing structure was implemented and evaluated. An administrative support team was developed to provide specialized internal consultation and support to a flattened and decentralized nursing division. The four administrative support team roles provided an organization perspective that ensured constancy of purpose throughout the division. This structural innovation proved to be congruent with nursing shared governance and total quality management initiatives occurring in the organization. Evaluation studies indicated that the model has effectively supported 5 years of continuing organizational change.

Hospital Bed Capacity, 300 to 499↗