A professional in any field needs the best tools of the trade. Along with new diagnostic technologies and pharmaceuticals, care management and documentation tools are required to plan, organize, monitor, and evaluate care. Under the umbrella term, Structured Care Methodologies, come a variety of tools. CCM helps organizations determine the type of Structured Care Methodology most needed, as well as develop the format, content, and policies.

The Problem (one or all may apply)

• Patient care is becoming more complex, but the various disciplines are not working well together.
• There is a need to involve the clinical leadership in the planning and implementation of programs and projects that will improve cost , quality, and satisfaction.
• Continuous Quality Improvement is important to the organization, but there is currently no formal group to tackle the issues needing resolution.

The Process

• Review of related data prior to onsite visits.
• Onsite team lead by CCM Principal or Senior Consultant.
• Education and facilitation of the selected collaborative practices.

Deliverables (negotiable)

• Initial written report, including structure and functional guidelines for the selected collaborative practices.
• Establishment of parameters, personnel, and goals of the selected collaborative practices.
• Research and tool development for the collaborative practices.
• Training of the collaborative practices.
• Facilitation of the collaborative practices.
• Formal evaluation.

Client example:

• At a large Midwest university medical center, CCM has facilitated the development of three formal collaborative practices: Cardiovascular Surgery, Bone Marrow Transplant (BMT) and Diabetes across the continuum. Over a period of 6-9 months per group, clinical leaders establish a Population-level DataMap® that serves as a guide for four areas of improvement: Financial, marketing/planning, clinical, satisfaction. One of the many outcomes is that the BMT group has shifted more care safely from inpatient to outpatient.

The Problem (one or all may apply):

• Physicians are complaining relentlessly.
• The organization is considering hospitalists.
• The organization wants more from the hospitalists.
• Physician contracts are pending.
• Physician leadership is changing.
• The Utilization Review Committee needs revision.
• Physicians want to decrease the number of committees and other meeting required of them.

The Process

• Review of related data prior to onsite visits.
• Initial interviews with key people on the phone to develop a smooth approach.
• Onsite interviews, observations, and meetings with key physicians and other stakeholders.
• Team lead by CCM Principal or Senior Consultant.
• Team includes at least one MD.
• Provide information and assistance as needed during the visits.
• Create a positive approach to problem-solving and change.

Deliverables (negotiable)

• Written report with assessment, recommendations, tools and examples as necessary to assist understanding and selection of options.
• Follow up visit for strategic planning and determination of next steps.
• Phone support via appointment for one year following visits.

Client examples:

• CCM provided a regional medical center in the Southwest with a written review of comparative fees for on-call specialty physicians. The hospital was able to use this objective information in its new cycle of contracting.
• Using CCM's MD Opinion of Case Management Survey, one client medical center was able to determine that its physicians generally had confidence in case managers, except for problems getting their patients from the ED to the units in reasonable time. This survey, which only requires five minutes of a physician's time, saved a lot of otherwise unnecessary reassignment of case managers. In addition, a focused consultation was provided for the ED to floor problem by facilitating a short-term stakeholder group to determine root causes and changes.