Avoidable Delay Management: How to Take Control of Your Length of Stay


Instructor: Toni Cesta
Product ID: 706053
Training Level: Intermediate

  • Duration: 60 Min
This webinar will help you identify factors that cause delays as patients progress through their stay and how to correct these barriers to care. Learn the most streamlined ways in which to integrate avoidable delay management into your day and with all the members of the interdisciplinary care team. Finally, it will review some examples of report cars that can be used to understand the data you have collected.
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Why Should You Attend:

The identification of avoidable delays (also called avoidable delays or variances) is a strategic role of the hospital case manager. It is integral to attaining good patient flow as patients progress through their hospitalization. Performing this role, however, is not easy. Having a hard-wired process with clear roles, as well as a database, better ensures that data is collect timely and that the data is accurate. If you are not clear on what avoidable delays really are or how to identify and capture them, this program is for you. And once you’ve entered them into a database how can they best be used to improve the length of stay is another question. This role is not an option anymore and every case manager needs to understand how it fits into their daily practice.

This webinar will focus on the role of the case manager in identifying avoidable delays. Capturing avoidable delays is the process used to ensure that patients experience good flow through the hospital stay and that delays are reduced or eliminated. We will review the common categories used to aggregate these delays and report on them. In addition, we will review the role of avoidable delay capture in the process of care coordination. Optimizing care coordination is key to reducing and managing length of stay but is sometimes overlooked or diminished in importance. How do case managers integrate these processes into their daily routines? First we must identify the delay and then we must work to correct it. We will review exactly how this is done. In addition we will discuss how length of stay management is also key in managing the CMS Efficiency Measure which scores your hospital on cost and length of stay. We will look at avoidable delays from the perspectives of access, through-put and discharge. We will conclude the program with examples of aggregated data and how this data can be used for quality improvement.

So many things can cause delays as patients progress through their stay and it’s our job to identify and correct these barriers to care. Learn the most streamlined ways in which to integrate avoidable delay management into your day and with all the members of the interdisciplinary care team. Finally we will review some examples of report cars that can be used to understand the data you have collected.

Areas Covered in the Webinar:

  • Define patient flow
  • Care coordination
  • Length of stay and the efficiency measure
  • Avoidable delay categories
  • Integrating care coordination and avoidable delays
  • Managing avoidable delays- the process
  • Entering avoidable delay data into a database
  • Aggregating and reporting avoidable delay data
  • Patient flow scorecard
  • Case management report care

Who Will Benefit:

  • Directors of Case Management
  • Directors of Social Work
  • RN Case Managers
  • Social Workers
  • Directors of Quality Management
  • Vice Presidents of Nursing
  • Directors of Finance
  • Vice Presidents of Operations
Instructor Profile:
Toni Cesta

Toni Cesta
Consultant and Owner, Case Management Concepts LLC

Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, new documentation systems, and other strategies for improving care and reducing cost. The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.

Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.

Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore – Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.

Dr. Cesta has been active in the research and development of case management for over 25 years. Her research in case management has included two funded studies measuring the effects of a case management model on congestive heart failure and fractured hip patient populations, with measures of patient satisfaction, quality of life, and short and long term clinical perceptions and outcomes.

Dr. Cesta has presented topics on case management at national and international conferences and workshops. Her books include “Nursing Case Management: From Essentials to Advanced Practice Applications”, “The Case Manager’s Survival Guide: Winning Strategies in the New Healthcare Environment”, “The Case Manager’s Survival Guide: Winning Strategies for Clinical Practice”, “Survival Strategies for Nurses in Managed Care” and “Core Skills for Hospital Case Managers”. Dr. Cesta is Consulting Editor of “Hospital Case Management Journal” and “Discharge Planning Advisor”. In addition, she serves as editorial advisory board member of several case management journals and publications including “Strategies for Healthcare Excellence” and “The Journal of Care Management”.

Dr. Cesta has a BS in Biology from Wagner College, a BS in Nursing from Adelphi University, an MA in Nursing Administration from New York University, and a Ph.D. in Nursing Research and Theory Development from New York University.

Dr. Cesta is a Fellow of the American Academy of Nursing. Among her awards are included the “Nursing Service Administration Award” from the New York State Nurses Association, the Jessie M. Scott Award for excellence in research, practice and education from the American Nurses Association, and three “Book of the Year” awards from the American Journal of Nursing. In 2010, she was awarded the Brooklyn Leaders Award from the Arthritis Foundation.

Topic Background:

Length of stay has always been one of the primary metrics for hospital case management. More recently, The Centers for Medicare and Medicaid Services (CMS) has added a new value-based measure called the “Efficiency Measure” which rates hospitals on their cost and length of stay. This makes length of stay more important than ever. Managing length of stay, when the reduction opportunities are small, means looking at new ways of determining how to reduce it. Case management plays an important role in this process.

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