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Care Coordination Models

"I call it our air traffic control system for the hospital."

Dan Moen, CEO, Sisters of Providence Health System

Ensure that everyone providing patient care does the right, most productive things, all the time, harmoniously on each unit and across all departments

Hospitals team with Care Logistics to adopt the best centralized care coordination model to efficiently anticipate, prioritize, coordinate, schedule, prepare for and track all patient movement, care, services and transport. This coordination of multiple people and departments establishes predictability and timeliness, improving throughput while best serving patients and caregivers.

Even with talented and dedicated staff, hospital departments don't hand off care activities efficiently because they operate with independent purposes and incentives. This creates tremendous variability, wasting time and frustrating patients and staff with delays that hinder patient care and extend length of stay. 

Some hospitals are ready to adopt a system-wide care coordination model. Care Logistics works with those hospitals to establish a hub-and-spoke approach that connects and coordinates all the right people and care activities:

  • Manage care activities and throughput across all people and departments
  • Help move from department-based care and services to care that focuses on the patient and goals of the entire hospital

The Hub: Care coordinators in the hub ensure proper patient placement, determine initial expected lengths of stay, and orchestrate all patient care resources. This central team also verifies insurance and makes all necessary payer notifications.

The Spokes: Care coordinators also staff patient care units, emergency and surgical departments, and ancillary areas across the hospital. These "spokes" ensure that patients flow efficiently and coordinate care with the physicians and other caregivers.

This care coordination model includes job descriptions, roles and responsibilities, and standard operating procedures for all areas of patient care. Care Logistics remains engaged with hospital teams throughout the rollout of the care coordination model and beyond, with regular reviews to ensure that care coordination continues to operate as smoothly and efficiently as possible.

Unit-Based Care Model: Other hospitals may be better served focusing first on efficient unit care models. Care Logistics works with those hospitals to adopt the most efficient patient progression model for unit care teams, which can include some or all of the following:

  • DRG Length of Stay Workgroups and Database
  • Daily Patient Progression SNAP Huddles
  • Executive Operational Rounding
  • Standardized Patient Progression Plans: 
  • Unit-Based Standard Operating Procedures

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