Stephanie Hong Patterns of Compliance with Case Management Follow Up after Referral
SchoolOrange High School
MentorPatricia Gant, RN, BSN, CCM
DepartmentCase Management at Hillcrest Hospital
Patterns of Compliance with Case Management Follow Up after Referral
The case management department is at about 85% compliance with its policy of holding a consult within 24 hours of a patient being admitted to the hospital.
A list of approximately 5,000 patient cases from Jan. 1, 2009, to June 8, 2009, was collected and every fourth patient was marked. Inclusion criteria included being an inpatient, being over 70 years old and needing a case management intervention. Of the 1,017 charts requested, 922 were successfully pulled.
Of the 922 charts, 608 had the case management/social work assessment progress note (roughly 66%). Of those, 458 occurred within 24 hours of admission (approximately 75%). However, the number of appropriate consults divided by the total number of charts shows the percent compliance to be about 50%. A fourth of the charts had consults, but not within 24 hours; 82% of those were admitted over the weekend. The greatest hindrance to reaching the ideal 85% compliance is weekend admissions. We recommend reevaluating staffing patterns, assigning weekend admission follow-ups to one person and re-evaluating the criteria which elicit a case management consult.