Hospital case management

Due to demographic changes, rising health expenditures, and the reimbursement mechanisms of insurers in the past 30 years, physicians and nurses have had to change the way services are delivered. Concepts such as cost effectiveness and patient safety have also led to the emergence of case management. Case management, usually led by nurses, is responsible for early recognition of patients at high risk for prolonged hospitalization, readmission, a high level of consumption of healthcare resources, and mobilizing strategies to discharge patients as soon as possible in a safe manner with appropriate medical follow-up. Additionally, the case management teams are responsible for patient education in a systematic way, for proper codification of diagnoses, and for ensuring proper documentation at the moment of discharge. Case management has proven to reduce the length of hospital stays and readmissions. It also facilitates the care of patients who are overwhelmed by the increasingly complex hospital procedures that they must endure. This is an exhaustive review of the literature about hospital-based case management, its origins, characteristics, types, and how it has produced a positive impact on patient safety and metrics within hospitals

Proceso de alta hospitalaria, revisión de la literatura

Discharge is one of the most important processes that hospitalized patients must endure. This process is complex, requires coordination among several professionals and transfers an overwhelming amount of information to patients. Often, it is limited to the writing of the discharge summary, with a primary emphasis on the drug list. Since the rise of hospitalism in 1996, a greater emphasis has been placed on understanding this process and in developing interventions to make it more effective and safe. In our country, little is known about how this process is taking place. Probably the absence of financial penalties for readmissions has influenced in the lack of study and development of this process. In the USA the knowledge of the discharge process is well advanced, and several strategies have been developed for reducing adverse events, medication errors, and 30-days readmissions. Other interventions have increased patient satisfaction and the degree of knowledge about their conditions. The aim of this paper is to do a comprehensive review of the literature, to provide healthcare teams with various tools that could improve both the discharge process as well as the discharge summary. The final objective is to optimize the safety and satisfaction of our patients and the hospital metrics of quality