Concurrent Review Takes Care to a Whole New Level

Concurrent review of three core measure sets has ensured appropriate and timely patient care. The hospital revised its review process from a postdischarge review and abstraction to a concurrent review and management while the patient is in the facility. Diagnoses outside of the primary diagnosis are also reviewed to ensure patients were not missed for inclusion in the review process. Daily management of evidence-based measures has ensured that all care given to patients is value-added, safe and patient centered. Outcomes for compliance were evaluated along with complications of care data. All outcomes improved from the implementation of the new process and were maintained over the course of the entire fiscal year 2014 and to date fiscal year 2015.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/