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Massachusetts General Hospital Anticoagulation Management Service Staffing, Budgets, Reimbursement and other Challenges

Massachusetts General Hospital Anticoagulation Management Service Staffing, Budgets, Reimbursement and other Challenges. Lynn B. Oertel, MS, ANP, CACP Clinical Nurse Specialist Presented November 4, 2008. Patients = 4100+ Mean age = 69 yrs, SD 13.65, range 20 - 100

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Massachusetts General Hospital Anticoagulation Management Service Staffing, Budgets, Reimbursement and other Challenges

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  1. Massachusetts General HospitalAnticoagulation Management ServiceStaffing, Budgets, Reimbursement and other Challenges Lynn B. Oertel, MS, ANP, CACP Clinical Nurse Specialist Presented November 4, 2008

  2. Patients = 4100+ Mean age = 69 yrs, SD 13.65, range 20 - 100 Common indications for treatment: AF  57% VTE  15% Heart Valves  9% INR intensity ranges 2 – 3  87% 2.5 – 3.5  9% By request, selected others Admissions: ~75/month + Reactivated patients ~ 60% new referrals from inpatient (POE Consult referral) Discharges: ~ 90/month Clinic overview

  3. Leadership (1.6+ FTEs) Robert Hughes, MD Co-Director Walter Moulaison, MS, RN Co-Director Lynn Oertel, MS, RN Clinical Nurse Specialist Administrative Support (4 FTEs) CiCi Teixeira,Office Manager Vivine Wilson Kristin Novak Vinh Huynh, Systems Specialist Nursing Staff (9.1 FTEs) Pat Biggs, RN Jen Chase, RN Rachel Corneau, RN Diane DeTour, RN Corin Gigler, RN Rosanne Landrigan, RN Jamie Legvold, RN Jen O’Neil, RN Palmie Riposa, RN Irina Seliverstova, RN Jamie Legvold, RN Donna Wolfrum, RN Anticoagulation Management Service at MGHStaffing

  4. Resources • AMS at MGH is largely hospital supported (AMS is under Patient Care Services, Department of Nursing) • AMS salaries are part of hospital wage and salary programs, as well as all other benefits

  5. MGH • Founded in 1811 • 3rd oldest general hospital in US • 900-bed medical center • 46,000 patient admissions • 1.5 million outpatient visits • Average length of stay is 5.84

  6. “… Patients are our primary focus, and the way we deliver care reflects that focus every day.” Vision Statement, Department of Nursing, MGH

  7. Workload • At MGH, focus is on patient needs • Currently use Quadramed Productivity and Benchmarking System for Inpatient Classification (Medicus) • Developing classification system for AMS outpatient workload measure

  8. AMS Risk Assessment Controlled (0-25) Low Watch (26-50) High Watch (51-75) Complex Care (>75)

  9. Financial Comments • Reimbursement –only for initial comprehensive outpatient education visit • Average volume 1400/year, budgeted revenue = $220,000 • Hospital perspective quality, safety & efficiency • Costs (budget) • Personnel salaries/benefits largest percentage of budget • Office supplies ~ $28,000/year • Postage ~ $29,000/year • Telephone/pagers ~ $18,000/year • Under development: workload measure for AMSusing RVUs (Relative Value Units - numeric value of the resources needed to provide services)

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