CLIENT PROJECT SUMMARIES

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Therapeutic IV Drug Decision Support

The rapidly changing oncology and hematology therapeutic drugs landscape creates confusion about referrals, medical appropriateness and payer reimbursement. Newly developed drugs have higher costs and higher payer resistance to reimbursement until proven, consistent protocols are established and followed. In this facility, increased referrals for outpatient infusion therapeutic drugs were creating unpredictable cost spikes and payer reimbursement process difficulties...

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Nosocomial Pressure Ulcer (NPU) Reduction

The administration’s annual mission to increase patient safety revealed opportunity to further reduce occurrences of NPUs (Bed Sores.) NPUs create extended length of stay, increased costs, patient pain and discomfort and increased risk for caregiver lawsuits....


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Lab Capacity and Clinic Flow Improvement

The clinic was struggling with timely processing of lab results for incoming patients. The delayed lab work was extending treatment times and causing a logjam in treatment and infusion rooms as well as the incoming patient waiting rooms. Managers were unsure how to determine manpower needs and struggled to deal with service peaks. The clinic managers had experimented by varying the staff levels within the laboratory with variable results...

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Operating Room Capacity Increase

Operating Room capacity limits caused surgeons to schedule procedures at other area facilities. A meeting with the hospital surgeons confirmed that if capacity could be increased, patients would be scheduled at this facility. This situation was directly and negatively affecting the facility’s bottom line. Increasing capacity by adding additional operating rooms was not an option as it was cost prohibitive and would take considerable time...

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Emergency Department (ED) Diverts Reduced

Investigation of diverts lead the facility to several contributing causes and an unexpected root cause. Since contributing causes for length of stay in the ED are: patient volume, staffing, and space, the ED increases staffing to drive faster turns and avoid diverts. This strategy was only effective if the hospital had inpatient beds available to put people flowing out of ER...

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Claims Reimbursement Improvement

A cumbersome claims process was creating a poor cash flow for the facility. They recognized the need to create a partnership with strategic insurance payers and to simplify their internal process for submitting claims to insurance carriers...

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