Athena Forum Institute ® 2016 Discover Athena Forum Tour! Company-Directed Training for Hospital Performance Company-directed training – to improve organizational performance. 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 & Publisher Senior Fellow, Jefferson School of Population Health [email protected] Discover Athena Forum Institute 2016 2 What’s your CM workforce strategy? n Knowledge workers need knowledge. Knowledge workers are different from factory workers. Knowledge workers can advance the strategic direction of your business. Peter Drucker The Essential Drucker® n Staff education is an essential function of leadership. The Joint Commission Hospital Accreditation Manual Discover Athena Forum Institute 2016 3 Define Management! n Management is getting work done through others. CM Team CM Director Social Workers UM Reviewers Discover Athena Forum Institute 2016 4 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.” Discover Athena Forum Institute 2016 5 Before and After Discover Athena Forum Institute 2016 6 Design Athena Forum was designed in 2008 by 400 care directors as a management tool and a national resource 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). Discover Athena Forum Institute 2016 7 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 webinars n Complimentary Staff Orientation webinars n Unlimited enrollments for all employees at site; hospitals can add or delete personnel at any time n 24/7 access to all 700 CE certificates (RN, SW, ACM & CCM; certs instantly printable from online n Accessible from all mobile devices (e.g. Nook, Kindle, iPad) at any Wi-Fi location n 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. Discover Athena Forum Institute 2016 8 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 managers on reducing avoidable days. Reducing only 10 days a year @ $2,300 saves $23K. $23,000 per year 2 Athena Forum s course Discharge Planning : instructs case managers on improving level of care (LOC). Assume one inpatient bed @ $2,300 vs. one SNF bed @ $375 = $1,925 savings X 10 transition orders = $19,000 savings per year. $19,000 per year 3 Athena Forum s course Improving Heart Failure Management : instructs case management teams to reduce HF re-admits by 20%. Assume avoiding 10 Medicare penalties on HF re-admit claims X $1,000 each = $10,000. $10,000 per year Total savings: $46,000 per year Discover Athena Forum Institute 2016 9 ROI Discussion Part 2 n “We’re seeing declines in hospital readmissions – coordinated with our course assignments to our 9 hospital CM teams. This is a great value.” Barbara Ashton RN MSN Regional Director Case Management HCA Mountain Division Salt Lake City, UT n “We’re forecasting improving claims by $100,000 a year. The price of high morale? Priceless!” Mindy Owen RN MS CCM Director Case Management Dartmouth-Hitchcock Lebanon, NH n “We’re training 380 care coordinators among our 80 medical groups all over Minnesota. 21st Century convenient.” Sue Robinson RN MS Manager ACO Education Allina Health Accountable Care Organization Discover Athena Forum Institute 2016 10 Benefits to Member Hospitals n 5 Benefits most frequently reported by 950 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 Discover Athena Forum Institute 2016 11 Athena Forum NEW Features for 30,000 CMs Being developed in 2016-2017: n Audio narrated courses n Facebook news: Athena Forum updates n Twitter feeds weekly: Athena Forum updates n Monday Memo news blasts: Athena Forum updates n “CM Excellence Series” monthly live & interactive webinars n LMS Workforce Performance feature: for CM Directors to manage all staff course completions Discover Athena Forum Institute 2016 12 Athena Forum Members Enrolling 25,000 Professionals Sample of 1,000 clients enrolling 25,000 health professionals as of February 2016: - Adventist Health, USA Allina Health ACO, MN Anthem, Inc. USA Baptist Health, TN Cambridge Health Alliance, MA Carolinas Health, NC Covenant Health, TN CHI Franciscan Health, USA Dartmouth-Hitchcock Health, NH Henry Ford Health System, MI - HCA Hospitals, USA Mayo Clinic Rochester, MN Molina Healthcare, USA Montefiore Hospitals, NY Mt Sinai Medical Center, FL Multi-Care, Inc., WA North Shore Jewish Health, NY Robert Wood Johnson Health, NJ Shriners Hospitals for Children, USA Saint Barnabas Health, NJ Discover Athena Forum Institute 2016 - Swedish Healthcare, WA SutterHealth, CA Tampa General, FL UC San Diego Healthcare, CA U. of Chicago Hospitals, IL U. of Florida Med Centers, FL U. of Texas Med Centers, TX U. of Utah Medical Center, UT U. of Georgia Med Centers, GA Duke Raleigh Health, NC 13 CCMC & Athena Forum Partnership! n “We’re thrilled to strengthen our relationship with Athena Forum. This partnership will deliver higher competencies to 50,000 case managers toward better practices and better patient care.” Patrice Sminkey RN CEO Commission for Case Manager Certification Mt Laurel, NJ n “We’re now embedding the CCMC’s Code of Conduct statements and Ethical Standards into our 125 courses to elevate case managers’ competencies towards excellence in care management.” Thomas A. Rasmussen CEO & Publisher Athena Forum Institute® Discover Athena Forum Institute 2016 14 Examples: CCMC Code of Conduct Statements n Principle 1: Board-Certified Case Managers (CCMs) will place the public interest above their own at all times. n Principle 2: Board-Certified Case Managers (CCMs) will respect the rights & dignity of all of their clients. n Principle 3: Board-Certified Case Managers will always maintain objectivity in their relationships with clients. n Principle 4: Board-Certified Case Managers (CCMs) will act with integrity and fidelity with clients and others. n Principle 5: Board-Certified Case Managers (CCMs) will maintain their competency at a level that ensures their clients will receive the highest quality of service. n Principle 6: Board-Certified Case Managers (CCMs) will honor the integrity of the CCM designation and adhere to the requirements for its use. n Principle 7: Board-Certified Case Managers (CCMs) will obey all laws and regulations. Discover Athena Forum Institute 2016 15 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). Discover Athena Forum Institute 2016 16 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. Discover Athena Forum Institute 2016 17 Sample Implementation Memo MEMO TO: FROM: DATE: SUBJECT: CM Staff CM Director January 2, 2016 2016 CM Team Program with Athena Forum: AUG-SEP-OCT Here is our next set of 3 courses from Athena you should complete for August, September and October. We’ll be discussing topics at monthly staff meetings. We look forward to improving all our CM services to our stakeholders. 2016 Courses on Athena Forum Improving Team Performance AUG CM Express on Athena Forum Mod B: Improving Claims Our CM team has a unique responsibility to get reimbursed for the pt care we deliver. This impacts the hospital’s revenues! We’ll discuss THU AUG 25 MTG 3pm. Bring CE SEP Hospital Revenue Cycle Mod B: Hospital Cash Flow Reducing avoidable days is an important task for us. Leadership supports. Print page 35 for the MTG. We’ll discuss THU SEP 29 MTG 3pm. Bring CE cert. OCT Heart Failure Management 1 Mod B: HF Assessment HF care is complex and expensive. The better we assess our HF Pts, the better care we provide Print chart “Family History Pertinent to HF.” Bring cert to 10.27 MTG Discover Athena Forum Institute 2016 18 Athena Forum Care Management Series® Slide 1 of 2 CM Express® [for new hires & onboarding] Establishing Your Professional Identity Mod A: Accelerating Your Performance Mod B: Importance Claims Mod C: Effective Resource Management Mod D: Enhanced Care Transitions Mod E: Standards, Credentials, Licensing & Codes of Conduct Mod A: Essentials Mod B: Critical Thinking Mod C: Emotional Intelligence Mod D: Conflict Resolution Mod E: Leadership Mod F: Difficult People CM Power ® [for advanced CM’s NOV 2016] Mod A: 5 Attributes of a High Performing CM Mod B: Optimizing Stakeholder Perf in the CM Sphere Mod C: CM Fiscal Focus in the Hospital Mod D: Hospital Strategy in Patient Engagement Discharge Planning Mod A: Philosophy & Standards Mod B: Patient Centered Approach Mod C: External Forces in DP Patient Advocacy & Engagement Mod A: Advocacy & Care Management Mod B: Right Care Guidelines for our Patients Mod C: Key Components to Care Success Ethics in Case Management Mod A: Ethical Standards of Practice Mod B: CM Ethics in the Hospital Setting Mod C: Ethics in the Telehealth Era Mod D: Ethics in Large Corporate Cultures Mod E: Ethics in the Community Health Setting Hospital Revenue Cycle [JUL 2016] Mod A: Significance of Operating Revenues Mod B: Building Revenue Cycle Teams Mod C: Medicare Claims & Reimbursement Mod D: Medicare Performance Mod E: Commercial Claims & Reimbursement Discover Athena Forum Institute 2016 19 Athena Forum Care Management Series® Part 2 of 2 Palliative & End-Of-Life Care Mod A: Advancing Palliative & EOL Care Mod B: Economics, Regulations and Reimbursements Mod C: Transdisciplinary Team in Palliative Care Mod D: Effective Communication in PC / EOL Care Mod E: Patient Goals & Expectations Mod F: Physical Symptom Management Mod G: Advance Planning, Grief & Bereavement Utilization Management Mod A: Dynamics & Structure Mod B: External Forces Mod C: Electronic Information Technology Mod D: Transdisciplinary Care Mod E: Key Quality Measurements Discover Athena Forum Institute 2016 20 Athena Forum Clinical Care Series® Slide 1 of 3 Asthma Diabetes Mod A: Prevalence & Pathophysiology Mod B: Assessment Mod C: Treatment Mod D: Care Manager’s Role in Asthma Mod A: Therapies Mod B: Assessments & Complications Mod C: Pharmacologic in Diabetes Care Mod D: CM Role & Pharmacologics Diabetes COPD Ebola Virus Care Management Mod A: Prevalence & Pathophysiology Mod B: Assessments & Complications Mod C: Pharmacologics in COPD Mod D: Care Manger’s Role Mod E: Pneumonia Mod A: American Societal Response & Ebola Assessments Mod B: Infrastructure for Control & Care; Legal Issues/Ebola Mod C: Patient Education & Reimbursements Ebola Care Discover Athena Forum Institute 2016 21 Athena Forum Clinical Care Series® Slide 2 of 3 Inflammatory Bowel Disease Obesity Management Mod A: Pathophysiology Mod B: Assessments Mod C: Patient Engagement Mod D: Pharmacologics Mod E: Non-Pharmacologic Treatments Mod A: Prevalence & Pathophysiology Mod B: Assessments & Complications Mod C: Treatments & Interventions Mod D: Care Manager’s Role in Obesity Management Heart Failure Pain Management Mod A: Prevalence & Pathophysiology Mod B: Assessment & Complications Mod C: Treatment & Interventions HF care Mod D: Case Manager’s Role in HF care Mod A: Pathophysiology of Pain Mod B: Acute Pain Mod C: Chronic Pain Mod D: Types of Chronic Pain Mod E: Pharmacologics in HF Care Mod F: Patient Engagement in HF Care Mod G: Transdisciplinary Team in HF Care Mod E: Cancer Pain Discover Athena Forum Institute 2016 22 Athena Forum Clinical Care Series® Slide 3 of 3 Sepsis Care Wound Care Mod A: Prevalence & Economics Mod B: Pathophysiology & Assessment Mod C: Sources & Predispositions Mod D: Prevention & Treatment Mod E: Care Manager’s Role in Sepsis Mod A: Prevalence & Pathophysiology Mod B: Assessments & Complications Mod C: Treatments & Interventions Mod D: Prevention Strategies Mod E: Care Manager’s Role in Wound Care Discover Athena Forum Institute 2016 23 Athena Forum Behavioral Health Series® Improving Outcomes in Abuse Management Mod A: Assess Domestic Violence Mod B: Interventions in Domestic Violence Mod C: Assess Child Abuse Mod D: Interventions in Child Abuse Mod E: Assess & Interventions in Elder Abuse Mod F: CM Role in Abuse Reporting & Management Improving Outcomes in Depression Care Mod A: Prevalence & Impact Mod B: Pathophysiology of Depression Mod C: Non-pharmacological Treatments Mod D: Pharmacology in Depression Care Mod E: CM Role in Depression Care Harm Risk Behaviors & Suicide Prevention Mod A: Prevalence & Societal Impact Mod B: Pathophysiology & Associated Mental Disorders Mod C: Assessment & Prevention Mod D: Treatment Management Mod E: CM Role in Suicide Prevention Discover Athena Forum Institute 2016 24 Athena Forum Provides 85% of Compliance Education Athena Forum’s course catalog supports the hospital’s staff education compliance measures by the Joint Commission Regulations and CMS.gov Hospital Quality Measures / STAR Categories: n n n n n n n n n n Heart failure 30-day all cause readmission Hospital based inpatient psychiatric services COPD UM requirements Hospital-associated infection Customer service and treatment (HCAHPS surveys) Appropriate transitions of care Medicare spending per beneficiary Post-operative complications Discover Athena Forum Institute 2016 25 Accreditations: RN, Social Work and CCM n Athena Forum offers 700 CE contact hours for RN, Social Work and CCM professionals. n RN: Athena Forum Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s COA. n RN California: Approved Provider with California Board of Nursing n RN Florida: Approved Provider with the Florida Board of Nursing and the Florida Department of Health. n Social Work: Approved CE Provider by the NASW in Michigan & New York. n Social Work in Michigan & New York. n CCM: Approved Provider of CCM CE by the CCMC (Certified Case Managers Commission) n Most courses meet CE requirements for CCM, ACM, RNBC Discover Athena Forum Institute 2016 26 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. Discover Athena Forum Institute 2016 27 Case Study #2 Tackling Hospital Priorities n n n Case Study 1: Reducing HF Re-Admits by 20% Timeframe: Athena courses: Discuss & integrate: Guest Speaker: 4 weeks: NOV 2015 Heart Failure: Pathophys, Assess, Treatments, CM Role 4 Staff Meetings: NOV 2015 Hospital Cardio Nurse Practitioner Case Study 2: Improving our UM Program Timeframe: Athena courses: Discuss & integrate: Guest Speaker: 8 weeks: APR-MAY 2015 UM: Pre-Admission Reviews, Concurrent Reviews, UR, Transitions 4 Staff Meetings: APR-MAY 2015 UR Manager from BlueCross Case Study 3: Improving Sepsis Care & Reducing LOS Timeframe: Athena courses: 4 weeks: NOV 2015 Sepsis Care & Resource Mgmt Discuss & integrate: Guest Speaker 4 Staff Meetings: NOV 2015 Hospital ICU Director Discover Athena Forum Institute 2016 28 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 28 case managers. My goal was to reduce avoidable days 30% within 4 months. I have total support of VP Operations. Discover Athena Forum Institute 2016 29 Case Study #4 The Book of the Month Club n n n Case Study 1: Improving our CM in the ED Program Timeframe: Athena course: Discuss & integrate: Book Club Discussion Leader: One month. Book - Principles in Case Management: CM in the ED CM Lunch & Learn meeting end of month. CM Director: CM s are thinking like management – fantastic! Case Study 2: Improving our Utilization Mgmt Timeframe: Athena course: Discuss & integrate: Book Club Discussion Leader: One month. Book - UM: Pre-Admission Reviews & Concurrent Reviews CM Lunch & Learn meeting end of month. CM Director: CM s have the best ideas on process improvement. Case Study 3: Improving Our Claims with Prior-Auth Timeframe: Athena courses: One month Book - MCO Prior-Authorization Discuss & integrate: Book Club Discussion Leader: CM Lunch & Learn meeting end of month. CM Director: CM s have new energy and confidence about prior-auth. Discover Athena Forum Institute 2016 30 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 launching a 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 in Personnel 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 2 FEB: Discharge Planning: Patient Centered DP 3 MAR: MCO Continuum: Prior Auth 4 APR: Asthma Pathophysiology 5 MAY: COPD Pathophysiology 6 JUN: CV Risk: Stroke & MI 7 JUL: Heart Failure Care: CM Role 8 SEP Pain Mgmt: Pathophysiology 9 OCT: Wound Care: Case Manager s Role 10 NOV: Sepsis & LOS Discover Athena Forum Institute 2016 31 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. Discover Athena Forum Institute 2016 32 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 Discover Athena Forum Institute 2016 33 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 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 n Discover Athena Forum Institute 2016 34 Athena Forum Management Team Tom Rasmussen CEO & Publisher Barbara Leach MS RN Director Nursing Education Senior Fellow Jefferson School Population Health Mindy Owen RN CRRN CCM Vice President Education Past President CMSA Former Chair CCMC Janice Graham Director Web Operations Ellen Fink-Samnick MSW LCSW CCM CRP Director Social Work Education Danae Manus MPA RHIA Director Course Design Sarah Hill Director Hospital Marketing Kim Billings Manager, Hospital Sales EAST Beverly Gulvin Manager, Hospital Sales WEST Athena Forum® LLC EIN # 20-5544409 Rockville, MD 20850 TEL 301-279-2160 Athena was the mythological Greek goddess of wisdom and prudent warfare. Discover Athena Forum Institute 2016 35
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