Utilization Review Department
The Utilization Review Department consists of three distinct departments:
1) Case Management, 2) Discharge Planning, and 3) Social Services. Although each department is separate, the staff must communicate with one another on a daily basis to help ensure effective patient care and successful discharge planning.
Case Management
The Case Management department consist of RNs or LVNs with experience working in a Long Term Acute Care hospital. Their responsibility is to review patient charts from the time a patient is admitted, throughout the hospital stay, and finally when he/she is discharged from the hospital. These reviews help to ensure that a patient continues to meet LTAC criteria. The case managers are in frequent communication with physicians and the interdisciplinary team members.
Discharge Planning
Discharge Planning includes the coordination of a patient’s discharge plan, whether the patient is going home, a Board & Care, skilled nursing facility, or subacute facility. The discharge planner has to communicate with patients, families, physicians, and the case managers to make sure that all parties involved are aware and agreeable to the discharge plan. The discharge planner also coordinates any other relevant issues, including home health, transportation, and other related matters.
Social Services
The responsibility of Social Services often involves a multitude of tasks. Each patient that is admitted into Vista Hospital is interviewed by the Social Worker. A psychosocial assessment is completed, and the patient’s family or other authorized representative. The social worker can meet with the patients or families if problems arise that require assistance. Each social worker has a minimum of a Bachelor’s degree. The social workers coordinate with case managers in planning weekly patient care conferences which also includes physicians and an interdisciplinary team to ensure an effective and efficient care plan for the patients.
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