Care management processes
The California Department of Health provides education and support to hospitals throughout the state, allowing many to create programs to address appropriate use of antimicrobials in response to State legislation.
A statewide program supports physician practices through multidisciplinary community-based health teams, preventive health expertise, easy access to needed information via electronic systems, and financial incentives, leading to lower utilization and growth in health care spending and enhanced provision of appropriate services.
A rural hospital's telemedicine-based antimicrobial stewardship program provides ongoing education and daily case reviews related to use of antibiotics, leading to more appropriate prescribing and less bacterial resistance to the drugs.
Hospitals participating in a collaborative used screening criteria, fast-track diagnostic testing, protocols to support the prompt initiation of treatment, and ongoing monitoring to reduce sepsis mortality by 54.5 percent.
Protocol-based care management tools and simplified documentation forms embedded in the electronic medical record improve documentation, the readability of notes, and coding accuracy in military health care facilities.
A health plan–sponsored disease management program targeting African Americans combines home blood pressure monitoring with culturally competent education and counseling, leading to better self-monitoring and blood pressure control.
Community outreach workers identify residents at risk of nursing home placement and arrange for them to receive appropriate home- and community-based services, leading to fewer nursing home placements and significant cost savings.
Intensive, person-centered case management, peer support, and a discretionary fund for adults with serious mental illness leads to better access to treatment, job training, and employment; fewer suicide/self-harm attempts, hospitalizations, incarcerations, and days of homelessness; and lower mental illness-related costs.
Primary care physicians order standardized bundles of tests and specialty referrals for common diagnoses, which are then managed by a care coordination team, resulting in expedited patient care and high physician satisfaction.
The combination of clinical alerts and decision support related to abnormal laboratory values had no impact on the clinical management of patients or the frequency of adverse events.