Planning For a Catastrophic Case Discharge
The following example highlights how Apricus care coordinators manage complex cases and their ability to go above and beyond for an injured employee. This case illustrates how coordinated specialty services with an outcomes-driven approach, offering quick coordination with a quality focus can make the journey easier for injured employees and their families.
A male employee in his twenties was injured on the job in a motor vehicle accident. The employee suffered a catastrophic injury and was diagnosed with paraplegia, a common spinal cord injury and lost muscle function in the lower half of his body including both legs.
After spending 30 weeks in a rehabilitation facility, he was ready to transition home. At this time, the injured employee’s case manager sent a discharge referral to Apricus.
Working together as a team, the Apricus coordinator and case manager reviewed the injured employee’s information and discussed discharge needs, including various durable medical equipment (DME) products, home health services and home modification. The discharge orders included:
- Home modification
- 24-hour RN home health aide services
- Vehicle modification
- DME supplies
- Specialized wheelchair
- Home lift system
The care coordinator then contacted the injured employee and his family. Because extensive home renovation was required to ensure wheelchair mobility in the home, it was crucial in this case to know if the injured employee lived by himself and who else might be available to assist. These questions helped ensure the injured employee received the right level of care moving forward and that the correct home modification needs would be met.
For the coordinator, the next step was to start with the most crucial item on the discharge order. In this case it was home health services and home modification. At Apricus, a specialized team works in tandem with the care coordinator to manage home modification due to the complexity and time needed to complete modifications. For the home health service, the coordinator has access to Apricus provider selection tools to search national vendors that can best handle the referrals and complete the request in the timeline specified.
Unfortunately, for this case the provider selection process proved difficult. Finding 24-hour care can be challenging, especially in rural areas which was the case with this injured employee. When the care coordinator ran out of national provider agencies, they expanded their search to smaller local agencies to meet his needs.
Communicating closely with the injured employee, medical providers and the case manager, Apricus removed obstacles related to discharge, including obtaining a 24-hour RN home health service and provided education and updates to the injured employee throughout the entire process. Apricus worked to establish trust with him ensuring they were engaged in his discharge process and vested in his health and well-being.
The Apricus Advantage
Not only does Apricus offer a one-stop-shop experience for all equipment and service needs, but care coordinators are trained to recognize that timely delivery of care demands a higher level of coordination and organization. On a regular basis, our coordinators work proactively with case managers and adjusters in requesting any information that is needed to facilitate an injured employees’ hospital discharge and avoid unnecessary delivery delays.
When it comes to hospital discharge planning, Apricus coordinators are actively involved in the evaluation and contracting of the services provided, ensuring access to care and clinical decision-making is well-timed, while serving as a compassionate voice and advocate for the injured employee.