Case Management Operational Redesign and Optimization

Case Management should rightfully be called “Care Coordination” with the goals of facilitating patient care throughout the care continuum. The broad scope of this discipline includes access management, care management, utilization review, discharge/transition planning, clinical population focus, high risk patient management, and process improvement. As we transition to Value Based Care, case management services are an early and essential signal to alert health systems of how efficiently & effectively they are performing. Hospitals have allocated precious resources for this department and sometimes case management is not able to produce quantifiable results and measures of departmental success.

How does your department measure up?

Is your Case Management operating efficiently? 

Do you know your Case Management department needs help, but you don’t know exactly how to start?

Is improving your hospital’s throughput a key to your future success?

Are your care processes inefficient, over engineered, overly complex or not meeting your goals?

Is your health system struggling to reduce avoidable readmissions, length of stay, denials, or to improve other outcomes?

Is your leadership team making progress toward your internal initiatives?

Has your EMR or Case Management Software been optimized to support your current workflow, assessment/content needs, or reports?

Is your staff over processing and duplicating documentation for productivity and outcome reports?

HCIT Consulting provides the knowledge, skills and expertise to assist you to optimize your hospitals Case Management Departments to improve workflow, process and outcomes. Specifically, HCIT Consulting can:

  • Evaluate Case Management and Social Work operations to support initiatives related to Length of Stay, Readmissions, Utilization Review, Denials, Avoidable Days, Discharge Planning, Cost of Care, and Post-Acute Care Transitions
  • Review staffing model, staffing ratios, and resource allocation.
  • Utilize evidenced-based methods to improve transitions of care.
  • Evaluate committee structures (UR), effectiveness, and management.
  • Review opportunities for optimal use of information systems and technologies to support workflow and enhance care transitions and the continuity of care.
  • Improve department efficiency and effectiveness based on assessment and data analysis.
  • Provide a GAP analysis and system selection for Case Management software systems.
  • Deliver resources for Interim Leadership for Case Management departments.

The clinical, financial, social and regulatory processes that your Case Management/Social Work Department is responsible for are without a doubt multi-factorial and very complex. HCIT Consulting, with our proven assessment and implementation methods, can lead your hospital or health system through a disciplined process to determine the changes needed to improve outcomes.

Process improvement and redesign is what we do and we would like the opportunity to assist your hospital leadership and staff to meet your improvement goals.  For more information, you may email us,