Care Management – Implementing It Successfully In Inpatient And Outpatient Settings – Part 2

Implementing Care Management initiatives for outpatients is just as important as it is for inpatients. In this article, we explore the essential requirements of a successful Care Management program when it comes to an outpatient setting.

Outpatients, especially those who are battling multiple chronic illnesses, are a highly susceptible group when it comes to falling prey to the perils of fragmented care. These people usually utilize the services of several specialty clinics, ERs and care facilities during their lifetime and as a result, often suffer from the consequences of poor transition and ill-managed care. By implementing Care Management initiatives for such High-Risk, High-Cost (HRHC) individuals, it is possible to enhance the quality of care and subsequently the results. Besides, such a program can help reduce the wastage of healthcare resources arising from a lack of interaction between various consulting specialists, unnecessary ER visits, and other similarities. It helps mitigate the risk of readmissions by improving patient awareness regarding post-discharge precautions, medication schedules, and preventative measures.

A few requirements that should be kept in mind to ascertain the success of a Care Management program in an Outpatient setting are as follows:

  1. Establishment Of Staff-Model Clinics – Providing patients the opportunity to get all services under one roof is a sure shot way of improving patient experience by maintaining continuity of care. Incorporation of ancillary services, specialty testing, and support services within your facility will help promote Care Management initiatives.
  2. Implementation of Special Programs For HRHC Patients – Organizing special clinics and running programs that target people who suffer from ailments like diabetes, hypertension, and obesity is beneficial in reducing costs and educating patients on how to practice self-care. Coumadin clinics and CHF clinics are also some examples of such interventions.
  3. Setting Up Urgent Care Centers – Urgent care clinics that offer 24*7 service are very useful in lowering the rate of ER visits and unnecessary readmissions, therefore, reducing costs and improving outcomes.
  4. Building A Centralized Referral System – By improving the flow of communication between PCPs, consulting specialists, and any other providers, a centralized referral system helps enhance the efficacy of the diagnosis as well as of the treatment plan.
  5. Regularly Training All Stakeholders – It is vital for both the clinical and the administrative staff to understand and be in alignment with the goals and workings of the Care Management program. Such integration can only be achieved by providing regular training to them.
  6. Hiring Patient Advocates And Liaisons – Patient advocates are typically trained nurses who are responsible for helping patients understand the nuances of the healthcare system that are applicable to them. These people ensure that patients do not feel lost in the intricate web of processes and policies that govern the healthcare lifecycle.
  7. Creation Of Community Resources – Setting up community centers, adult day-care centers, access centers, and other similar facilities to help the indigent are a good step towards implementing a holistic Care Management program.
  8. Educating Vulnerable Target Groups – Population education through lectures, literature, and engagement can help improve health outcomes by making patients capable enough to take proper care of themselves.
  9. Appreciating The Holistic Nature Of Medicine – Paying attention to alternative healing methods can help augment the efficiency of the treatment plans implemented.

Building a positive relationship with patients in both inpatient and outpatient settings is essential to ensure the overall effectiveness of Care Management initiatives. The points listed above can help you build such relationships with your patients irrespective of whether they are admitted into your facility or not.

This article is the second part of a two-part series. To read the first part click here


Sign up for the daily newsletter: