High quality and lower cost: they can coexist!

The need to control costs must be balanced with consumers' demands for high quality in their health care. An integrated approach that uses a multidisciplinary team, a case manager, and a clinical path to improve the quality of patient care offers one method by which both goals may be achieved. The report details the results of a case study in which these three elements were applied to the care of patients undergoing total hip replacement surgery. Results included a length of patients' stay of 3.92 days, cost reduction of $667 per patient in direct costs, no reported cases of readmission for complications during the 2 year process, reductions in length of stay for patients referred to extended care facilities, and a shortened period in home health services. These results are attributed to extensive use of prior screening for all patients by multiple care disciplines, better patient education processes before admission and surgery, improved communication between team members on patient progress, and coordination of care across the continuum.