By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
List strategies for assigning status of patients not clearly meeting interqual criteria.
Explain the role of the physician advisor.
Define the challenges within your hospital.
Evaluate stratification plans and design revenue cycle processes.
Discuss strategies to help physicians understand the importance of admitting patients in observation status while still providing quality service, staying compliant and creating more earnings.
Review sample worksheet material to show how to apply the rules step by step to calculate the observation hours.
Explain the tools to meet CMS requirements.
Compare what LOS should be for observation patients versus admission status patients.
Describe tools to capture the most revenue possible with observation patients.
Explain how to align all disciplines (nursing, physicians, case managements and ancillary) to move observation patients through the system more efficiently.
Review the rationale and benefits of having a dedicated unit.
Discuss how to size and staff the unit based on a hospital's resources.
Identify the ideal staffing matrix for your hospital.
Describe how to optimize utilization of the Observation Unit.
List the screening tools implemented to ensure key points of entry funnel through one process.
Discuss how to educate staff across departments.
Summarize the meaning of observation status and the importance of applying it correctly from the beginning.
Explain how to successfully educate physicians in a manner that is meaningful to clinicians.
Discuss how to align physician and hospital goals when applying observation status.
Identify the responsibilities of the staff actually performing the work (i.e.: ER Nurse, Case Manager, Ambulatory Surgery Staff and Admitting/Registration Staff).
Explore the consequences of using the incorrect "Level of Care" status.
Discuss how to ensure that admission criteria is applied consistently across the board.
Summarize the importance of pre-approved treatment and diagnostic protocols to decrease time in the Observation Unit.
List inclusion and exclusion criteria for Observation Unit patient admission.
Explain how a closed Observation Unit can free-up beds and save hospitals money.
Explain how to get paid for observation care by commercial payors and Medicare advantage.
Describe how to avoid pitfalls that disqualify payment.
Explore ways to persuade health insurance plans to invest in an observation unit.
Identify ways to improve the relationship between the emergency department and the observation unit.
Explain how a fee for service group can bill for both emergency and observation services.
Discuss ways to overcome medical staff resistance.
What questions have arisen in your practice for which you need answers/strategies that you can implement?
Are you interested in basic, intermediate or advanced level trainings?
What barriers might you have that would interfere with implementation of new information learned from this training?
How can this training be improved to better impact competence, performance and/or patient outcomes?
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