Development of a program to manage costly outliers

Area of Science:

• Gerontology
• Healthcare Management
• Nursing Practice

Background:

• Elderly patients with multisystem failure often require complex nursing care.
• Identifying patients at risk for high healthcare costs and extended hospital stays is crucial for resource management.

Purpose of the Study:

• To develop a method for identifying clinical variables associated with 'outlier' patients.
• To implement proactive nursing strategies for managing high-risk elderly patients.

Main Methods:

• Defined 'outliers' as patients exceeding $50,000 in hospital charges or a length of stay beyond their diagnostic group.
• Established criteria to identify potential outliers early in their hospital course.
• Developed nursing strategies for monitoring, intervention, and outcome evaluation.

Main Results:

• A clear definition and criteria for identifying outlier patients were established.
• Nursing strategies were developed to proactively manage care for at-risk elderly patients.
• The program aims to align resource needs with availability for complex care.

Conclusions:

• Proactive identification of outlier patients enables early nursing intervention.
• Targeted nursing strategies can improve care management and resource allocation for elderly patients with multisystem failure.
• This approach seeks to optimize patient outcomes and healthcare resource utilization.