Athena Forum Institutehcm.athenaforum.com/fileStorage/AthenaForumMgmt_ AUG2015.pdf ·...

Athena Forum Institute®

2015 Discover Athena Forum Tour!”Company-Directed Training for Hospital Performance”

Discover Athena Forum Institute 2015 2

The Journey of CM Improvement Begins on Athena Forum.

Dear CM Director,

Our philosophy is that a CM Director can achieve goals at a faster rate with a better educated staff.

Thanks to all the CM Directors contributing to this presentation.

Welcome!

TOM RASMUSSEN

Thomas A. Rasmussen CEO & PublisherSenior Fellow, Jefferson School of Population Health [email protected]


Human Capital

n “Knowledge workers need knowledge. Knowledge workers are different from factory workers. Knowledge workers can advance the strategic direction of your business.”

Peter DruckerThe Essential Drucker®

n “Staff education is an essential function of leadership.”Joint CommissionHospital Accreditation Manual

Define Management!

n “Management is getting work done through others.”


CM Director

CM Team

Social Workers

UM Reviewers


The Education Multiplier Effect

n When ONE CM completes ONE CE course = “advancing one’s practice.”

n When the ENTIRE team completes the same course = “improving organizational performance.”

~ “Company-directed training is the tide that lifts all boats.”

Before and After



Design

Athena Forum was designed in 2008 by 400 care directors as a management tool and a nationalresource for workforce development.

Athena Forum has 3 Personalities that can improve organizational performance:

1. Management Tool: CM Directors assign courses to steer the team to hospital priorities.

2. CE Resource for Staff: Staff love Athena Forum for 700 CE accessed from any computer.

3. Safe Search Engine® 7,000 page database is searchable (“21st Century PDR” says CM).

Pricing

4 Levels of Hospital Educational Site Licenses:

1. ALPHA hospital ( > 500 licensed beds) $7,500.00 per year

2. BETA hospital (300-499 beds) $5,500.00 per year

3. CHARTER hospital (100-299 beds) $3,500.00 per year

4. DELTA hospital, med group, SNF ( <99 beds) $1,100.00 per year

All benefits available to all hospitals:n Complimentary Management Orientation webinarsn Complimentary Staff Orientation webinarsn Unlimited enrollments for all employees at site;; hospitals can add or delete personnel at any timen 24/7 access to all 700 CE certificates (RN, SW, ACM & CCM;; certs instantly printable from onlinen Accessible from all mobile devices (e.g. Nook, Kindle, iPad) at any Wi-Fi locationn Tuition pricing for personnel outside the hospital: see “ACO Presentation” or contact [email protected]

Athena Forum Value Proposition: Invest a little – go BIG on staff performance.


Return-On-Investment Part 1

n Many hospitals forecast a conservative ROI of 10 X Athena $3,500.

n 3 cost-savings examples from 3 CM Directors: Annual Savings:

1 Athena Forum’s course “Hospital Revenue Cycle” instructs case managerson reducing avoidable days. Reducing only 10 days a year @ $2,000 saves $20K. $20,000 per year

2 Athena Forum’s course “Discharge Planning”: instructs case managers onimproving level of care (LOC). Assume one inpatient bed @ $2,000 vs. one SNF bed@ $375 = $1,625 savings X 10 transition orders = $16,000 savings per year. $16,000 per year

3 Athena Forum’s course “Improving Heart Failure Management”: instructscase management teams to reduce HF re-admits by 20%. Assume avoiding 10Medicare penalties on HF re-admit claims X $1,000 each = $10,000. $10,000 per year

Total savings: $46,000 per year


ROI Discussion Part 2

n “We’re seeing declines in hospital readmissions – coordinated with our course assignments to our 9 hospitalCM teams. This is a great value.”

Barbara Ashton RN MSNRegional Director Case ManagementHCA Mountain DivisionSalt Lake City, UT

n “We’re forecasting improving claims by $100,000 a year. The price of high morale? Priceless!”Mindy Owen RN MS CCMDirector Case ManagementDartmouth-HitchcockLebanon, NH

n “We’re training 380 care coordinators among our 80 medical groups all over Minnesota. 21st Century convenient.”Sue Robinson RN MSManager ACO Education Allina Health Accountable Care Organization


Benefits to Member Hospitals

n 5 Benefits most frequently reported by 650 CM Directors on Athena Forum:

1. Elevated core competencies of case managers

2. Improved outcomes

3. Reduced avoidable days

4. Improved claims

5. Reduced readmissions risks


Maximizing the Power of Staff Development

n CM Directors on Athena Forum report 3 essentials to maximize the power of staff development:

1. CM Director should assign courses to steer the team (popular pacing is 1 module per month).

2. CM Director should lead monthly discussions (for staff compliance & hospital’s procedures).

3. CM Director should delegate details of staff completions (to admin, senior CM or an educator).


Athena Forum Supports Your ACO

n The Affordable Care Act requires hospitals in an Accountable Care Organization to:

1. Demonstrate your preventive care program for our covered Medicare seniors in community,

2. Demonstrate your chronic care delivery network for covered seniors in community,

3. Demonstrate your staff coaching process to adhere to Medicare’s 5 Patient Quality Measures.


Sample Implementation Memo

MEMO TO: CM StaffFROM: CM Director DATE: January 2, 2015SUBJECT: Staff Performance Program 2015 with Athena Forum

As mentioned, we’re launching a new staff development program with courses on Athena Forum. This is a mandatory program for all CM staff and will improve our organizational effectiveness as all staff will be taking the same courses as we move forward. This is also a new and free employee benefit. We’ll be discussing topics at monthly staff meetings. We look forward to improving all our CM services to patients, families, nursing and payers.

2015 Staff Performance Program Advancing Practices & Team Performance______________________

JAN CM Express on Athena Forum Our CM team has a unique responsibility to get reimbursed for the pt care we deliver. Mod B: Improving Claims This impacts the hospital’s revenues! We’ll discuss THU JAN 29 MTG 3pm. Bring CE

FEB Hospital Revenue Cycle Reducing avoidable days is an important task for us. Leadership supports.Mod B: Hospital Cash Flow Print page 35 for the MTG. We’ll discuss THU FEB 26 MTG 3pm. Bring CE cert.

MAR Heart Failure Management 1 HF care is complex and expensive. The better we assess our HF Pts, the better careMod B: HF Assessment we provide Print chart “Family History Pertinent to HF.” Bring cert to MTG 3.26.


Athena Forum Care Management Series® Slide 1 of 2

CM Express® [for new hires] Establishing Your Professional IdentityMod A: Essentials of CM: Be Pro-Active & a Problem Solver Mod A: EssentialsMod B: Importance of Claims Mod B: Critical ThinkingMod C: Resource Management Mod C: Emotional IntelligenceMod D: Transitions of Care / Patient Experience Mod D: Conflict Resolution

Mod E: LeadershipCM Power ® [for advanced CM’s DEC2015] Mod F: Difficult PeopleMod A: 5 Attributes of a High Performing CMMod B: Optimizing Stakeholder Perf in the CM Sphere Ethics in Case ManagementMod C: CM Fiscal Focus in the Hospital Mod A: Ethical Standards of Practice Mod D: Hospital Strategy in Patient Engagement Mod B: CM Ethics in the Hospital Setting

Mod C: Ethics in the Telehealth EraDischarge Planning Mod D: Ethics in Large Corporate CulturesMod A: Philosophy & Standards Mod E: Ethics in the Community Health SettingMod B: Patient Centered ApproachMod C: External Forces in DP Hospital Revenue Cycle

Mod A: Industry Cash Flow

Patient Advocacy & Engagement Mod B: Hospital Cash FlowMod A: Advocacy & Care Management Mod B: Right Care Guidelines for our PatientsMod C: Key Components to Care Success


Athena Forum Care Management Series® Part 2 of 2

Commercial Population Healthcare [DEC2015] Senior Care Series® [2016]Mod A: Chronic Care Management for a Population Improving Medicare Claims 10%Mod B: Healthcare Analytics & Metrics for Success Mod 1: SepticemiaMod C: Tele-health Coaching & Care Transitions Mod 2: Osteoarthritis

Mod 3: CHF (non-hypertensive)Palliative & End-Of-Life Care Mod 4: Complications Grafts-Implants-DeviceMod A: Advancing Palliative & EOL Care Mod 5: PneumoniaMod B: Economics, Regulations and Reimbursements Mod 6: AMIMod C: Transdisciplinary Team in Palliative Care Mod 7: Coronary AtherosclerosisMod D: Effective Communication in PC / EOL Care Mod 8: Respiratory Failure Mod E: Patient Goals & Expectations Mod 9: Cardiac DysrhythmiasMod F: Physical Symptom Management Mod 10: Acute Cerebrovascular DiseaseMod G: Advance Planning, Grief & Bereavement

UM & Resource ManagementMod A: Standards & Regulations in UM Mod B: Payers, Contracting & UMMod C: Quality of Care & UM


Athena Forum Clinical Care Series® Slide 1 of 3

Asthma CV Risk: Stroke & MIMod A: Prevalence & Pathophysiology Mod A: Prevalence & PathophysiologyMod B: Assessment Mod B: Stroke & The Care Manager’s RoleMod C: Treatment Mod C: MI & The Care Manager’s RoleMod D: Care Manager’s Role in Asthma

DiabetesMod A: TherapiesMod B: Assessments & ComplicationsMod C: Pharmacologic in Diabetes CareMod D: CM Role & Pharmacologics Diabetes

COPD Ebola Virus Care Management Mod A: Prevalence & Pathophysiology Mod A: American Societal Response & Ebola AssessmentsMod B: Assessments & Complications Mod B: Infrastructure for Control & Care;; Legal Issues/EbolaMod C: Pharmacologics in COPD Mod C: Patient Education & Reimbursements Ebola CareMod D: Care Manger’s RoleMod E: Pneumonia


GI Disorders Obesity ManagementMod A: Ulcerative Colitis Mod A: Prevalence & PathophysiologyMod B: Crohn’s Disease Mod B: Assessments & ComplicationsMod C: Diverticulitis Mod C: Treatments & Interventions

Mod D: Care Manager’s Role in Obesity Management

Heart Failure Pain ManagementMod A: Prevalence & Pathophysiology Mod A: Pathophysiology of PainMod B: Assessment & Complications Mod B: Acute PainMod C: Treatment & Interventions HF care Mod C: Chronic PainMod D: Case Manager’s Role in HF care Mod D: Types of Chronic PainMod E: Pharmacologics in HF Care Mod E: Cancer PainMod F: Patient Engagement in HF CareMod G: Transdisciplinary Team in HF Care




Sepsis Care Wound Care Mod A: Prevalence & Economics Mod A: Prevalence & PathophysiologyMod B: Pathophysiology & Assessment Mod B: Assessments & ComplicationsMod C: Sources & Predispositions Mod C: Treatments & InterventionsMod D: Prevention & Treatment Mod D: Prevention StrategiesMod E: Care Manager’s Role in Sepsis Mod E: Care Manager’s Role in Wound Care


Athena Forum Behavioral Health Series®

Improving Outcomes in Abuse Management [FEB 2015]Mod A: Domestic Violence 1Mod B: Domestic Violence 2Mod C: Child Abuse 1Mod D: Child Abuse 2Mod E: Elder AbuseMod F: CM Role in Abuse Reporting & Management

Improving Outcomes in Depression Care Mod A: Prevalence & ImpactMod B: Pathophysiology of DepressionMod C: Non-pharmacological TreatmentsMod D: Pharmacology in Depression CareMod E: CM Role in Depression Care

Harm Risk Behaviors & Suicide Prevention Mod A: Prevalence & Societal ImpactMod B: Pathophysiology & Associated Mental DisordersMod C: Assessment & PreventionMod D: Treatment ManagementMod E: CM Role in Suicide Prevention


Accreditations: RN, Social Work and CCM

n Athena Forum offers 700 CE contact hours for RN, Social Work and CCM professionals.

n RN: Co-Provider with SutterHealth University by American Nurses Credentialing Center [ANCC]

n RN California: Approved Provider with California Board of Nursing

n RN Florida: Approved Provider with the Florida Board of Health in Nursing.

n Social Work: Approved CE Provider by the NASW in 38 states.

n Social Work in California, Michigan & New York.

n CCM: Approved Provider of CCM CE by the CCMC (Certified Case Managers Commission)



Case Study#1 The Strategic Staff Development Program

1. Assess Department Weaknesses- High LOS at “X” days – commercial payers complaining.- Heart Failure Re-admits too high – Medicare financial penalties will grow. - Avoidable days too high – costs $thousands monthly- Need CM clinical skills – RN managers on units say our CM clinical skills are rusty. - Denials too high -- Need better percentages, especially with BlueCross. - Problems with RAC auditors incoming – rumors not good.

2. Develop Positive Strategy - Lower the LOS to “Y” days- Reduce HF re-admits by 20% - Improve denial management to “Y”%

3. Assign Athena Forum Courses to Case Managers for Improved Competencies - Discharge Planning & UM & Hospital Revenue Cycle- Heart Failure Assessments, Treatments & Case Manager’s Role in Reducing HF Re-admits- Principles of Case Management & Standards of Practice

4. Discuss & Integrate Performance Program - Delegate to senior case manager implement discussions on courses & hosp policy. Consider Gift Certificates to Best Buy, etc)- Invite guest speakers from hospital, payers, RAC auditors, others. Outside perspectives add value. - Listen for opportunities to make process improvements.


Case Study #2 Tackling Hospital Priorities

n Case Study 1: Reducing HF Re-Admits by 20%Timeframe: 4 weeks: NOV 2014Athena courses: Heart Failure: Pathophys, Assess, Treatments, CM RoleDiscuss & integrate: 4 Staff Meetings: NOV 2014Guest Speaker: Hospital Cardio Nurse Practitioner

n Case Study 2: Improving our UM ProgramTimeframe: 8 weeks: APR-MAY 2015Athena courses: UM: Pre-Admission Reviews, Concurrent Reviews, UR, TransitionsDiscuss & integrate: 4 Staff Meetings: APR-MAY 2015Guest Speaker: UR Manager from BlueCross

n Case Study 3: Improving Sepsis Care & Reducing LOSTimeframe: 4 weeks: MAR 2015Athena courses: Sepsis Care & Resource MgmtDiscuss & integrate: 4 Staff Meetings: MAR 2015Guest Speaker Hospital ICU Director


Case Study #3: Reducing Avoidable Days

CM Director:

“Our 350 bed hospital has an unacceptable level of avoidable days at 50 days a month. At $1900 a bed night that’s $95,000 monthly in losses.That’s $1.1M yearly.

“I assigned your course on Hospital Revenue Cycle to my 28case managers.

“My goal was to reduce avoidabledays 30% within 4 months. I havetotal support of VP Operations.”


Case Study #4 The Book of the Month Club

n Case Study 1: Improving our CM in the ED ProgramTimeframe: One month. Athena course: “Book” - Principles in Case Management: CM in the ED Discuss & integrate: CM Lunch & Learn meeting end of month. Book Club Discussion Leader: CM Director: “CM’s are thinking like management – fantastic!”

n Case Study 2: Improving our Utilization MgmtTimeframe: One month. Athena course: “Book” - UM: Pre-Admission Reviews & Concurrent ReviewsDiscuss & integrate: CM Lunch & Learn meeting end of month. Book Club Discussion Leader: CM Director: “CM’s have the best ideas on process improvement.”

n Case Study 3: Improving Our Claims with Prior-AuthTimeframe: One monthAthena courses: “Book” - MCO Prior-AuthorizationDiscuss & integrate: CM Lunch & Learn meeting end of month. Book Club Discussion Leader: CM Director: “CM’s have new energy and confidence about prior-auth.”


Case Study #5 Competency Program for Social Workers

CM Director:“Our Social Workers can benefit from improving competencies in clinical care and CM business. In 2015 I’m launchinga Social Worker Competency Program -- using 10 courses from Athena Forum. Each of our 5 Social Workers will be required to complete the following 10 courses on Athena -- at the rate of about one course per month (sooner if they want to). I’m giving them a vacation break in August and Holiday break in December.

“Each Social Worker will submit the 10 SW certificates from Athena to our Dept Admin -- who will then file the certs inPersonnel Jackets. When I meet for performance reviews in December, I will expect to see 10 certificates as proof of performance. And of course, they can print each cert a second time for their license. Win-win. Big picture is that we can now offer our Social Workers a new resource in clinical ed so they can contribute more to our dept performance.”

Social Worker Competency Program with 10 Athena Forum Modules 2015:

1 JAN: Hospital Revenue Cycle: Hospital Cash Flow 6 JUN: CV Risk: Stroke & MI2 FEB: Discharge Planning: Patient Centered DP 7 JUL: Heart Failure Care: CM Role3 MAR: MCO Continuum: Prior Auth 8 SEP Pain Mgmt: Pathophysiology 4 APR: Asthma Pathophysiology 9 OCT: Wound Care: Case Manager’s Role5 MAY: COPD Pathophysiology 10 NOV: Sepsis & LOS

Case Study #6 Core Competencies & Compensation

n Multi-Hospital System (5 hospitals) in Seattle area

n CM Director: “Athena Forum education is our core staff competency program for our 100 CMs.”

n CM Director: “I assign 10 Athena modules yearly. Certs get filed in each employee’s HR file.”

n CM Director: “During annual performance review meetings < 10 certs = no raise.”

n CM Director: “With staff changes, a maternity leave and a transfer, we’ve had 100% compliance.”

n CM Director: “We don’t measure all metrics, but we see noticeable improvements in 5 teams.”



21st Century Learning by Case Managers

n Starbucks: “About once a month I take my laptop to Starbucks with their Wi-Fi and read a course on Athena. No one bothers me plus I get to sip on my Grande Latte while learning something new”

Case Manager, San Fran, CA.

n Hospital Medical Library: “It’s quiet in the library, so I go down the hall once in awhile to take a course on Athena Forum with my laptop. I only wish the librarian allowed me to eat a sandwich there, but you can’t have everything in life.”

Case Manager, Seattle WA

n Late Night at Home: “I’m married with 2 kids and am on 2 church committees plus the job, so time is precious. I have learned that when the boss assigns a course, I am able to take a late Saturday night at home to read a course on the site. It’s my quiet time for learning.”

Case Manager, Newark NJ

n Early Morning Cubicle: “When the boss assigns a new course on Athena Forum I show up super early the next morning in my cube and take the course ASAP. Good business concepts.”

Case Manager, Atlanta, GA


What does excellence sound like?

n “Thank you for the training this morning, it was exactly what we needed.” CM Director VA

n “Our team is ecstatic to have such an amazing tool at their fingertips.” CM Director WY

n “Athena has exceeded our expectations. Keep up the good work!” CM Director TX

n “The format of Athena Forum is very user friendly.” CM Director CA

n “Conversations are getting more professional. Social Workers love this.” CM Director IL

n “We know it. We trust it. We love it.” CM Director TN

n “Starbucks is the new Learning Café for our younger gen case managers.” CM Director WA

n “Athena is the tide that lifts all boats.” CM Director NY


Athena Forum Management Team

Tom Rasmussen Barbara Leach MS RN Mindy Owen RN CRRN CCMCEO & Publisher Director Nursing Education Vice President EducationSenior Fellow Past President CMSAJefferson School Population Health Former Chair CCMC

Janice Graham Ellen Fink-Samnick MSW LCSW CCM CRP Danae Manus MPA RHIADirector Web Operations Director Social Work Education Director Course Design

Sarah Hill Kim Billings Beverly GulvinDirector Hospital Marketing Manager, Hospital Sales EAST Manager, Hospital Sales WEST

Athena Forum® LLCEIN # 20-5544409Rockville, MD 20850 TEL 301-279-2160

Athena was the mythological Greek goddess of wisdom and prudent warfare.

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