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Design and implementation of an inpatient disease management program.
Am J Manag Care. 2000 Jul; 6(7):793-801.AJ

Abstract

OBJECTIVE

To describe the development and implementation of an inpatient disease management program.

STUDY DESIGN

Prospective observational study.

PATIENTS AND METHODS

On the basis of opportunities for improving quality or efficiency of inpatient and emergency department care, 4 diagnoses, including congestive heart failure (CHF), gastrointestinal hemorrhage, community-acquired pneumonia and sickle-cell crisis were selected for implementation of a disease management program. For each diagnosis, a task force assembled a disease management team led by a "physician champion" and nurse care manager and identified opportunities for improvement through medical literature review and interviews with caregivers. A limited number of disease-specific guidelines and corresponding interventions were selected with consensus of the team and disseminated to caregivers. Physician and nurse team leaders were actively involved in patient care to facilitate adherence to guidelines.

RESULTS

For quarter 2 to 4 of 1997, there were improvements in angiotensin-converting enzyme inhibitor use, daily weight compliance, assessment of left ventricular function, hospital costs, and length of stay for care-managed patients with CHF. Differences in utilization-related outcomes persisted even after adjustment for severity of illness. For the other 3 diagnoses, the observational period was shorter (quarter 4 only), and hence preliminary data showed similar hospital costs and length of stay for care-managed and noncare-managed patients.

CONCLUSIONS

An interdisciplinary approach to inpatient disease management resulted in substantial improvements in both quality and efficiency of care for patients with CHF. Additional data are needed to determine the program's impact on outcomes of other targeted diagnoses.

Authors+Show Affiliations

Department of Medicine, University Hospitals of Cleveland and Case Western Reserve University School of Medicine, Cleveland, OH, USA. gxc12@po.cwru.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11067376

Citation

Cooper, G S., et al. "Design and Implementation of an Inpatient Disease Management Program." The American Journal of Managed Care, vol. 6, no. 7, 2000, pp. 793-801.
Cooper GS, Armitage KB, Ashar B, et al. Design and implementation of an inpatient disease management program. Am J Manag Care. 2000;6(7):793-801.
Cooper, G. S., Armitage, K. B., Ashar, B., Costantini, O., Creighton, F. A., Raiz, P., Wong, R. C., & Carlson, M. D. (2000). Design and implementation of an inpatient disease management program. The American Journal of Managed Care, 6(7), 793-801.
Cooper GS, et al. Design and Implementation of an Inpatient Disease Management Program. Am J Manag Care. 2000;6(7):793-801. PubMed PMID: 11067376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Design and implementation of an inpatient disease management program. AU - Cooper,G S, AU - Armitage,K B, AU - Ashar,B, AU - Costantini,O, AU - Creighton,F A, AU - Raiz,P, AU - Wong,R C, AU - Carlson,M D, PY - 2000/11/7/pubmed PY - 2000/11/7/medline PY - 2000/11/7/entrez SP - 793 EP - 801 JF - The American journal of managed care JO - Am J Manag Care VL - 6 IS - 7 N2 - OBJECTIVE: To describe the development and implementation of an inpatient disease management program. STUDY DESIGN: Prospective observational study. PATIENTS AND METHODS: On the basis of opportunities for improving quality or efficiency of inpatient and emergency department care, 4 diagnoses, including congestive heart failure (CHF), gastrointestinal hemorrhage, community-acquired pneumonia and sickle-cell crisis were selected for implementation of a disease management program. For each diagnosis, a task force assembled a disease management team led by a "physician champion" and nurse care manager and identified opportunities for improvement through medical literature review and interviews with caregivers. A limited number of disease-specific guidelines and corresponding interventions were selected with consensus of the team and disseminated to caregivers. Physician and nurse team leaders were actively involved in patient care to facilitate adherence to guidelines. RESULTS: For quarter 2 to 4 of 1997, there were improvements in angiotensin-converting enzyme inhibitor use, daily weight compliance, assessment of left ventricular function, hospital costs, and length of stay for care-managed patients with CHF. Differences in utilization-related outcomes persisted even after adjustment for severity of illness. For the other 3 diagnoses, the observational period was shorter (quarter 4 only), and hence preliminary data showed similar hospital costs and length of stay for care-managed and noncare-managed patients. CONCLUSIONS: An interdisciplinary approach to inpatient disease management resulted in substantial improvements in both quality and efficiency of care for patients with CHF. Additional data are needed to determine the program's impact on outcomes of other targeted diagnoses. SN - 1088-0224 UR - https://www.unboundmedicine.com/medline/citation/11067376/Design_and_implementation_of_an_inpatient_disease_management_program_ L2 - https://www.ajmc.com/pubMed.php?pii=880 DB - PRIME DP - Unbound Medicine ER -