Hybrid Embedded Case Management: New Model for Cross-Continuum Care Coordination

Sea Girt, NJ, October 01, 2014 --(PR.com)-- When a typical embedded and telephonic case management program didn’t yield desired results--namely, coordination of quality care for their high-cost, high utilizers with complex, chronic diseases--Sentara Healthcare System took steps to correct it.

"Hybrid Embedded Case Management: New Model for Cross-Continuum Care Coordination" documents Sentara's retooled and highly effective version, where Sentara's RN case managers now meet patients where they are—at home, in the hospital, in the primary care provider office, on the phone or online via Skype® or FaceTime® virtual sessions. This approach has reduced overall cost of care by 17 percent for Sentara's highest risk, highest cost patients.

In this 25-page resource, Mary M. Morin, RN, NEA-BC, RN-BC, nurse executive with Sentara Medical Group, details the care management overhaul that dramatically reduced ER utilization, hospital admissions and readmissions among high-risk 'VIPs.' Among the care management outcomes were reductions in all cause inpatient admissions by 48 percent; and all cause admissions by 21 percent; and improvements in seven-day follow-up rates by nearly double, from 50 percent to 98 percent.

Learn more about hybrid embedded case management for cross-continuum care coordination at http://store.hin.com/product.asp?itemid=4943

News Facts: Ms. Morin provides details on the following:

-An ambitious care management program that includes advance care planning and a strict seven-day follow-up metric;
-Sentara's seven-pronged population health management model;
-Composition and responsibilities of the care team, which includes providers, RN care managers, PharmDs and newly added social workers;
-Nuts and bolts of Sentara's RN Care Management model, including patient assignments, core competencies, work flows, communication, education and training;
-Addressing the behavioral and community health needs of vulnerable, high-risk VIPs;
-The nine key roles of the RN case manager, including care plan development, care transition management and advance care planning;
and more.

Learn more about hybrid embedded case management for cross-continuum care coordination at http://store.hin.com/product.asp?itemid=4943

Report Formats: Print, PDF, Print/PDF combination and site license.

Quote attributable to Melanie Matthews, HIN Executive VP And COO:
"Sentara's revamped hybrid approach to embedded case management was able to improve outcomes for both patients and physician practices by establishing and maintaining patient-centered relationships. This resource will prove useful to those looking to enhance their current case management program and promote patient-centered population health."

For Melanie Matthews' profile, please visit http://www.hin.com/bios.html#mm

Please contact Patricia Donovan to arrange an interview or to obtain additional quotes.

About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 449-4463, e-mail info@hin.com, or visit http://www.hin.com.