PP07 – Agents of change: How to lead in value-based care
In value-based care, case managers are charged with improving patient care, but often the tools and technology at their disposal are outdated and inefficient. Faxes, Post-it notes, and other manual, disconnected systems sap up valuable time and create roadblocks to effective post-discharge care plans. Case managers need integrated, strategic tools that analyze and monitor patients’ recovery and facilitate the creation of tight partner networks to provide quality care across the continuum.
As the liaison between patients and the hospital or health system, case managers are poised to be the change agents in their organizations. For instance, at one large health care system in the South, case managers focused on implementing technologies to improve discharge planning and workflows, standardizing care across the continuum, and forming a tight network of partners that share the value-based mindset. Through these initiatives, the system has greatly improved the quality of care patients receive: To date, it has decreased readmission rates by more than 15 percent when patients received the recommended level of care, and simultaneously lowered costs.
This presentation will deliver real-world examples and best practices honed over three decades of clinical field work to empower case managers to initiate and lead their organizations in the updating of technologies and processes both within the hospital and across their PAC networks. Attendees will learn about tools and strategies to form stronger partnerships and networks of collaborative care teams, and deliver better care that gets patients home sooner and keeps them out of the hospital.