SHM Converge Scientific Abstract ePoster Gallery-Expanding the Role of the Case Manager and Physician Advisor: Helping Others to Think Outside the Box

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The document describes a redesign of multidisciplinary rounding and care management workflows to improve hospital throughput, communication, and cost performance.<br /><br />In the previous state, care managers were assigned geographically while providers were not, leading to seven separate concurrent MDRs, poor ancillary staff attendance, weak collaboration, and no clear escalation pathways. Hospitalist groups were inconsistently engaged, and case managers spent about three hours daily re-checking charts because communication was inefficient. Only about 30% of hospital volume was reviewed with providers.<br /><br />The current state shifted to a global MDR model. Care managers now cover 1–2 providers each in a non-geographic dyad, with a dedicated 10-minute discussion slot for each provider. Before MDR, the care manager and provider spend 15 minutes reviewing patients together. A centralized MDR tracker captures updates, barriers, and escalations and is shared hospital-wide after rounds. The MDR is led by a PA or administrative representative and includes in-person participation from physicians, care managers, social work, and hospital staff, while PT/OT, pharmacy, nursing leadership, CDI, and surgical services join by Zoom. Key operational issues such as OR/Endo schedules, readmissions, and inappropriate orders are brought to the meeting.<br /><br />The future state includes piloting an afternoon throughput meeting focused on green/yellow patients, with geographic provider assignments and provider-aligned care managers.<br /><br />Outcomes of the new model include fewer calls and chats, faster real-time escalation resolution, improved relationships, and house-wide visibility through the tracker. Financially, the first nine months showed a reduction in capped ODI from 1.07 to 0.76 and estimated LOS cost savings of $2.49 million.

Asset Subtitle

Carol Gilmore

Meta Tag

Author List Carol Gilmore, Danni Fore

Category Innovations

Concept Provider-Aligned Care Management

Concept Multidisciplinary Rounding

Concept Case Manager

Concept Provider

Concept Workflow

Distinguished Non-Finalist

Presenter Organization CHI St Joseph Hospital

Presenting Author Carol Gilmore

Track Other

Keywords

multidisciplinary rounding

care management workflows

hospital throughput

provider communication

global MDR model

care manager dyad

centralized MDR tracker

real-time escalation

length of stay savings

hospital cost performance

Provider-Aligned Care Management

Multidisciplinary Rounding

Case Manager

Provider

Workflow