In June 2009, there was an explosion in a large plant. At the time of the blast, about 300 workers were in the plant. Some suffered severe burns and many were exposed to toxic fumes from ammonia leaks.
Area hospitals took in 38 injured workers. Of those, 20 were employees transported immediately following the explosion. The remaining 18 went later, either reporting minor injuries or heat exhaustion.
Managing such a catastrophic event was complex. The expertise of a multidisciplinary team of professionals was required to ensure the highest quality patient care and coordinate both human and material resources.
This case study illustrates the seamless collaboration of partners working to produce the most effective and efficient results. As you will note, early intervention, well-defined communication channels and the unparalleled clinical expertise of MSC Care Management’s professionals made the essential difference.
PLANNING/STAGING (12-24 hours post-event)
MSC Care Management established a dedicated team of Catastrophic Registered Nurses to assign responsibilities.
MSC established dedicated phone and email lines to ensure continuity of communication with their customers – nurse care managers, claims adjusters, physicians, hospital discharge planners and patients. To further facilitate communications during this critical period, MSC distributed a dedicated team contact sheet, listing all key participants with their most recent contact information (including phone numbers and email addresses) for resource management.
An MSC Registered Nurse established contact with assigned field nurse case managers.
Based on discussions between customers and MSC’s professionals, and the anticipated severity of the injuries (blast injuries, penetrating injuries, blunt trauma), MSC established a preliminary workflow to coordinate the provision of necessary services and products at the appropriate points in time.
MSC’s team then triaged the community provider in MSC’s network to identify those with the appropriate scope of skills for specialty management of burns and wounds.
MSC’s professionals coordinated with our customers in interdisciplinary team meetings to review the scope of injuries and forecast activities needed to manage treatment plans for injured workers.
EXECUTION (24 hours+)
MSC proactively contacted discharge planners at regional hospitals within a 60-mile radius of the event to help them manage transitional care needs for injured workers.
Optimal Care Transportation specialists coordinated with local transportation providers and area hospitals and customers to facilitate arrangements for transporting patients to burn centers, rehab centers or home discharge following initial emergency triage. The Optimal Care team also ensured that special needs transportation was on standby.
The community’s physician network was identified to manage evaluations for possible hearing aids as a result of blast trauma injuries.
In collaboration with our customers, MSC’s professionals identified claimants with high-exposure and catastrophic injuries, established follow-up protocols and provided clinical updates to facility case management personnel as needed.
As with all of the catastrophically injured claimants on service with MSC, MSC’s Catastrophic Registered Nurses compiled clinical case summaries with the most up-to-date clinical and treatment information on each injured worker.
A skilled RN from MSC’s team of professionals was on call 24/7 and an after-hours and weekend protocol was created to ensure continuity of care management of injured workers and to handle weekend discharges.
MSC’s professionals assessed each patient discharged from the hospital via internal clinical triage. MSC’s local providers made a home call to each claimant on service within 24 hours of discharge to assess patient needs and ensure a successful transition to home, with the necessary support services.
MSC’s home health and transportation teams collaborated to develop a customized reporting process to track and report physician follow-up appointments with injured workers and ensure new orders were given and filled immediately in accordance with a claims examiner’s authorization.
Weekly meetings were between MSC’s professionals and our customers regarding the still-hospitalized high-severity patients to coordinate on discharge planning and preparation of special-needs support (ventilator and oxygen coordination, burn management, post-acute treatment of toxic exposures, etc.).
MSC designated a highly skilled Catastrophic RN to monitor ongoing homecare needs and maintain communication among all parties regarding the injured worker’s transition to home and continuing needs.
Appropriate Care: The services used fit diagnoses and injury severity levels.
Increased Efficiency and Reduced Administrative Burden for Customers: Field nurse case managers worked efficiently directing care through the collaborative, cross-functional MSC home health and transportation teams.
Collaborative Approach Leverages MSC’s Expertise to Support Customer Decision-making: This clinical support of the MSC nurse through the treatment plan and utilization review in collaboration with the customer ensures the appropriate level and duration of care.
MSC’s Management of Provider Network Ensures High Penetration and Cost-Effective Care: Due to MSC’s existing broad and deep provider network, as well as its visibility within the provider community and with local hospitals through close contact with physicians, providers and discharge planners at the time of the event, orders for products and services are managed in-network, ensuring care is well coordinated and cost-effective.