Avoidable Delay Management: How to Take Control of Your Length of Stay

Why Should You Attend:

The identification of avoidable delays (also called avoidable delays or variances) is a strategic role of the hospital case manager. It is integral to attaining good patient flow as patients progress through their hospitalization. Performing this role, however, is not easy. Having a hard-wired process with clear roles, as well as a database, better ensures that data is collect timely and that the data is accurate. If you are not clear on what avoidable delays really are or how to identify and capture them, this program is for you. And once you’ve entered them into a database how can they best be used to improve the length of stay is another question. This role is not an option anymore and every case manager needs to understand how it fits into their daily practice.

This webinar will focus on the role of the case manager in identifying avoidable delays. Capturing avoidable delays is the process used to ensure that patients experience good flow through the hospital stay and that delays are reduced or eliminated. We will review the common categories used to aggregate these delays and report on them. In addition, we will review the role of avoidable delay capture in the process of care coordination. Optimizing care coordination is key to reducing and managing length of stay but is sometimes overlooked or diminished in importance. How do case managers integrate these processes into their daily routines? First we must identify the delay and then we must work to correct it. We will review exactly how this is done. In addition we will discuss how length of stay management is also key in managing the CMS Efficiency Measure which scores your hospital on cost and length of stay. We will look at avoidable delays from the perspectives of access, through-put and discharge. We will conclude the program with examples of aggregated data and how this data can be used for quality improvement.

So many things can cause delays as patients progress through their stay and it’s our job to identify and correct these barriers to care. Learn the most streamlined ways in which to integrate avoidable delay management into your day and with all the members of the interdisciplinary care team. Finally we will review some examples of report cars that can be used to understand the data you have collected.

Areas Covered in the Webinar:

• Define patient flow
• Care coordination
• Length of stay and the efficiency measure
• Avoidable delay categories
• Integrating care coordination and avoidable delays
• Managing avoidable delays- the process
• Entering avoidable delay data into a database
• Aggregating and reporting avoidable delay data
• Patient flow scorecard
• Case management report care

Who Will Benefit:

• Directors of Case Management
• Directors of Social Work
• RN Case Managers
• Social Workers
• Directors of Quality Management
• Vice Presidents of Nursing
• Directors of Finance
• Vice Presidents of Operations

Laura Ostrowsky
President, NYC chapter of CMSA

Laura Ostrowsky RN, CCM MUP is the current president of the NYC chapter of CMSA and a Director on the national CMSA board. She teaches a CCM prep course with the Case Management Institute, works with Athena Forum, and writes andconsults on case management and related topics. Laura has published articles on Case Management in CMSA Today, Professional Case Management, Case in Point, The Patient Flow Journal and other periodicals. She regularly presents at national conferences including CMSA, the Patient Advocate Institute, NTOCC and others on topics ranging from case management, patient flow and payer provider collaboration to advocacy, collaborative practice and case management’s role in the changing health care environment.

Laura is a past Director of Case Management at Memorial Sloan-Kettering Cancer Center (1999-2019) and the 2012 CMSA Case Manager of the Year. Her program was been nominated by Case in Point for excellence in Utilization Management, Discharge Planning and Transitions in Care and awarded the patient Advocate Award. She created a patient advocacy program to assist patients in obtaining access to specialty care despite network restrictions. The program has been featured in articles in Advance for Nursing, The Wall Street Journal, Case in Point, and Case Management Monthly.

Laura holds a master’s degree in Health Planning and Policy from Hunter College.

Laura has 40 years of health care experience, including time as a staff nurse, QA Coordinator, Director of UR and QA, followed by directorships in CM at New York Presbyterian (NYP) and Memorial Sloan Kettering Cancer Center and providing educational presentations as part of the Genentech Speaker’s Bureau.

Topic Background:

Length of stay has always been one of the primary metrics for hospital case management. More recently, The Centers for Medicare and Medicaid Services (CMS) has added a new value-based measure called the “Efficiency Measure” which rates hospitals on their cost and length of stay. This makes length of stay more important than ever. Managing length of stay, when the reduction opportunities are small, means looking at new ways of determining how to reduce it. Case management plays an important role in this process.

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