7:30 am
What topics are on your mind?

Join your colleagues and discuss the latest industry trends over coffee

8:30 am
Christopher Caspers
Christopher Caspers, MD
Chief, Observation Medicine, NYU Langone Health System;
Associate Professor, NYU School of Medicine;
President-Elect, Observation Medicine Section, American College of Emergency Physicians

8:45 am

After implementing observation units in hospitals, providers must adapt shifting priorities and new strategies to instill continuous improvement. It is critical for teams to identify areas that can be improved to stay ahead of the curve while aiming for high quality assurance and patient satisfaction. In this session, learn how to manage daily operational needs of observation care in order to continuously improve quality and care.

  • Assess daily operational tasks that would lead to increased efficiency, profitability, and create a formula for success — proactive vs reactive responses
  • Identify critical areas to emphasize quality assurance and coordinate quarterly meetings to enhance units performance and recognize “red flags”
  • Discuss the barriers to assuring continued success and the approaches necessary to overcome them
  • Discuss rationale in receiving and treating simple vs complex patients
Dean Harrison
Dean Harrison, MPAS, PAC, DFAAPA
Director, Clinical Evaluation Unit; Director, Advanced Practice Providers; Director, EM/APP Residency Program, Assistant Professor
Duke University Medical Center

9:30 am

Managing higher acuity patients in observation care involves uncertainties that prevent providers from increasing the population and complex diagnoses treated. By broadening the scope of diagnoses treated in observation care, hospitals can reduce hospital bed footprint and overall savings. In this session, determine the steps necessary to expand the diagnoses treated in observation care.

  • Evaluate the appropriate staffing model to continuously maintain high productivity and provide high quality care while broadening the population treated
  • Partner with service lines to decrease readmissions and get buy-in from hospital consultants
  • Establish pathways for more complex patients with higher acuity and optimize existing templates and order sets
Stefanie B. Porges
Stefanie B. Porges, MD
Medical Director, Emergency Department Observation Unit
Hospital of the University of Pennsylvania

J. Jeremy Thomas
J. Jeremy Thomas, MD, MBA, FACEP, FAAEM
Director, Emergency Services and Observation Medicine
University of Alabama at Birmingham, UAB Health System

10:45 am

Identifying metrics and interconnectivity between multiple benchmarks can be a complicated task; however, establishing quality metrics is an important aspect in determining the progress of health care provisions in observation care. In this session, discuss common metrics used and establish standardized criteria.

  • Pinpoint fundamental data that can be used, ones that may be missed or misinterpreted, and establish standardized criteria
  • Discuss how upgrading patients from observation to inpatient status is affecting readmissions
  • Examine methods to improve observation conversation rates without affecting other quality metrics
Chris Turner
Chris Turner, MD, MMHC
Hospitalist, Internal Medicine and Pediatrics
Medial Director, Maury Regional Medical Center Clinical Decision Unit
Maury Regional Medical Group

11:30 am

Hospitals across the nation face constraints with inpatient bed capacity, specifically with behavioral health and psychiatric patients. Observation can be used by providers who are looking for alternatives to alleviate ED overflow while maintaining a level of high quality care. In this session, discuss acute behavioral care that can be given under observation status and establish necessary workflows and protocols

  • Explore the benefits of treating psychiatric patients in observation care and determine the protocols, optimal workflow, and staffing model needed
  • Strengthen collaboration between providers and social workers to ensure continuous care flow
  • Assess the impact of establishing an independent unit for this patient population
  • Outline the process to design and implement an unit tailored to behavioral health patients and the resources needed
Christopher McStay
Christopher McStay, MD, FACEP, FAWM
Chief, Clinical Operations; Associate Professor, Department of Emergency Medicine
University of Colorado School of Medicine

12:15 pm
1:30 pm

It is crucial to understand the boundaries that can be pushed in terms of patient acuity in observation care and how to treat those patients appropriately and safely. Patients with complex diagnoses such as sickle cell diseases, diabetic ketoacidosis, and sepsis do not always fit the criteria frameworks set by hospitals, making it difficult to determine the appropriate level of care. Discuss how observation care can play a significant role in hospitals and health systems to better manage care required for these populations.

  • Establish appropriate staff support, medical management, and discharge processes for complex diagnoses and obtain consult support and buy-in
  • Identify resources outside of the hospital that providers can collaborate with and together better manage these patient populations
  • Discuss what protocols must be implemented and identify metrics and benchmarks that can be used to impact outcomes, readmissions, and length of stay
Moderator:
Christopher Caspers
Christopher Caspers, MD
Chief, Observation Medicine, NYU Langone Health System;
Associate Professor, NYU School of Medicine;
President-Elect, Observation Medicine Section, American College of Emergency Physicians

Panelists:
Joseph B. Borawski
Joseph B. Borawski, MD, MPH, FACEP
Medical Director, Clinical Evaluation Unit
Assistant Director, Acute Care Research Assistant
Professor, Division of Emergency Medicine
Duke University Medical Center

J. Jeremy Thomas
J. Jeremy Thomas, MD, MBA, FACEP, FAAEM
Director, Emergency Services and Observation Medicine
University of Alabama at Birmingham, UAB Health System

Amit Wadhwa
Amit Wadhwa, MD, FAAEM
Medical Director, Utilization and Care Management
Holy Cross Health

2:15 pm

Shared with Physician Advisor and Medical Director Summit


In the 2018 OPPS Final Rule, CMS removed TKR from the Medicare IPO list. Since there is a significant difference between payment rates made via DRG system and outpatient observation services, hospitals and health systems must understand how to navigate through regulation changes without having a negative financial impact.

  • Review the policy changes on TKA and the impact it has on providers and patients
  • Design workflows for inpatient and outpatient procedures and determine the best care setting for your patient
  • Discuss how appropriate documentation of medical necessity can help care facilitators
  • Asses lessons learned and current state of total knee replacements to uncover the future direction for this procedure
Amit Bansal
Amit Bansal, MD, FACP, FHM
Physician Advisor,
Rochester Regional Health
Director of Quality,
Rochester General Hospital Group

Deerajnath Lingutla
Deerajnath Lingutla, MD, MBA, CHCQM
Medical Director/Physician Advisor Program; Academic Hospitalist,
Rochester Regional Health/Unity Hospital
Clinical Assistant Professor of Medicine
University of Rochester

3:00 pm

Shared with Physician Advisor and Medical Director Summit


Determining the final status of a patient while being compliant to regulations is an essential yet complex function of Physician Advisors. A critical step to assessing the best care level for a patient is understanding the intricacies of length of stay in observation and in-patient settings and how they affect payment received by the hospital. In this session, explore innovative ways of managing observation and in-patient admissions, and how payment and documentation is affected under different settings.

  • Understand the equivalency of a DRG payment under observation status, and how it differs between Medicare and commercial payers
  • Examine what needs to be taken into consideration to build out documentation to support medical necessity for inpatient admission
  • Evaluate cases of one-day inpatient stay and identify critical clinical indicators that reveal the possibility of shorter stays of less than two midnights
Carissa J. Tyo
Carissa J. Tyo, MD
Assistant Professor, Internal and Emergency Medicine; Program Director, IMEM Combined Residency; Medical Director, Clinical Decision Unit; Physician Advisor,
University of Illinois at Chicago Hospital and Health Sciences Systems