[lhol]

In trying to improve our Core Measures compliance, we are looking for new ways to do things. I am looking for ideas

[AfloydRN]

Our case manager has to sign off on all of those before a patient can be discharged. Pain in the butt- Yes- but so far it has worked.

[Nikkinu]

Trying to get our case managers to sign off on core measures wouldn't work with us. We try to do concurrent chart review. It's hard on the pneumonia and SCIP, by the time we get them it's to late.

[Sterling'sAunt]

What elements are the hardest for you in regards to compliance?

[Nikkinu]

Heart Failure is our most difficult element. There are so many different hands in the pot it's hard to get a handle on it. Between the physicians and nursing, it's a real up hill battle for us. Pneumonia is also difficult, but are sample size is larger and we have a little bit more to play with.
Nikkinu

[Sterling'sAunt]

We have struggled with the heart failure LV assessment and ACEI/ARB elements as well. We have put into practice the steps that the case manager is responsible to get the LV assessment on the chart even if it is pulling from a previous admission or calling the physician's office and then the discharging nurse is not to discharge the patient until the ACEI/ARB has either been ordered or documentation as to why not, for those patients who have the EF <40. For the education elements, we built those into the discharge instructions template so each had to be addressed.

Pneumonia: We have a pneumonia pathway that includes all the elements but to get them to use it ahs been a stuggle. The last review showed much better compliance with that, but I must say I was really surprised.

We have a contract ED MD group and I have started meeting with the medical director and the company each month on those not met in the ED. I hope that helps as well.

Not sure if any of this helps or not but thought I would let you know what we are doing here.