How can you identify areas of low utilization in case management?
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Case management is a complex and dynamic process that requires careful planning, coordination, and evaluation of services and outcomes for clients. One of the challenges that case managers face is identifying areas of low utilization, or underuse, of available resources and interventions that could benefit their clients and improve their quality of care. Low utilization can result from various factors, such as lack of awareness, access, or motivation, or mismatch between client needs and service offerings. In this article, we will discuss how you can use data visualization and reporting tools to detect and address low utilization in case management.
Low utilization can have negative consequences for both clients and case managers. For clients, low utilization can mean missing out on opportunities to enhance their health, well-being, and self-sufficiency. For case managers, low utilization can mean wasted time, effort, and money, as well as reduced satisfaction and performance. Low utilization can also indicate gaps or inefficiencies in the case management system, such as poor communication, coordination, or referral processes, or inadequate training or support for case managers.
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KIKELOMO ALUKO MSN, RN
Psychiatry Registered Nurse, Advanced Clinician/Utilization Review Nurse/Clinical Informatist at Sharp Healthcare
Low utilization can be a problem if the client or patient is not receiving medical or psychiatric care in the appropriate care setting which can lead to employers and insurers financial loss
Utilization is a measure of how much and how often clients use the services and interventions that are available and recommended for them. Utilization can be measured at different levels, such as individual, group, or program level, and with different indicators, such as frequency, duration, intensity, or adherence. To measure utilization, you need to collect and analyze data from various sources, such as client records, service logs, surveys, or feedback forms. You also need to define and compare the actual and expected utilization rates for each service or intervention, based on the client's goals, needs, and preferences.
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KIKELOMO ALUKO MSN, RN
Psychiatry Registered Nurse, Advanced Clinician/Utilization Review Nurse/Clinical Informatist at Sharp Healthcare
Utilization can be measured by reviewing and collecting data of the patient before and during an admission to determine the necessity of admission and ongoing treatment.
Visualizing utilization data can help you identify patterns, trends, and outliers in the data, and communicate your findings and recommendations to stakeholders. You can use various data visualization tools, such as charts, graphs, maps, or dashboards, to display and explore your utilization data. For example, you can use a bar chart to compare the utilization rates of different services or interventions, a line chart to track the utilization changes over time, a map to show the geographic distribution of utilization, or a dashboard to summarize the key utilization metrics and indicators.
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KIKELOMO ALUKO MSN, RN
Psychiatry Registered Nurse, Advanced Clinician/Utilization Review Nurse/Clinical Informatist at Sharp Healthcare
Can be visualize through documentation, charts, graphs and logs of the patient being reviewed, thus will determine the progress or the decline of the care
Reporting on utilization data can help you share your insights and actions with your clients, colleagues, managers, or funders. You can use various reporting tools, such as reports, presentations, or newsletters, to convey your utilization data in a clear and concise way. For example, you can use a report to document your utilization analysis and recommendations, a presentation to highlight your utilization achievements and challenges, or a newsletter to update your stakeholders on your utilization activities and outcomes.
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KIKELOMO ALUKO MSN, RN
Psychiatry Registered Nurse, Advanced Clinician/Utilization Review Nurse/Clinical Informatist at Sharp Healthcare
Through the use of various applications and sharing of the data and information collected. Also via voice calls, virtual meetings and facsimile
Improving utilization can help you optimize the use of resources and interventions for your clients and enhance their case management outcomes. You can use various strategies to improve utilization, such as educating, engaging, and empowering your clients, collaborating and coordinating with your service providers and partners, monitoring and evaluating your utilization performance and impact, and adapting and innovating your utilization practices and policies. For example, you can educate your clients about the benefits and expectations of the services and interventions, engage them in the decision-making and goal-setting processes, and empower them to take charge of their own care. You can also collaborate and coordinate with your service providers and partners to ensure that the services and interventions are accessible, appropriate, and effective for your clients. You can also monitor and evaluate your utilization performance and impact to identify and address any issues or gaps, and adapt and innovate your utilization practices and policies to respond to the changing needs and preferences of your clients and the case management environment.
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KIKELOMO ALUKO MSN, RN
Psychiatry Registered Nurse, Advanced Clinician/Utilization Review Nurse/Clinical Informatist at Sharp Healthcare
Ensuring patients are pre registered, insurance and all IDs are correctly verified before pt is admitted . Collaborating with the attending Dr and discharge planner upon pt presentation to facility