11 Mar SmartSteward™ Operational Results
SmartSteward reduces infections and resistance by automating and integrating the infection control and antibiotic stewardship processes in a Skilled Nursing Facility. Improved patient health outcomes lower the cost of care, increase revenue and are associated with significant intangible benefits. The early results from the pilot facility are promising.
This chart demonstrates the reduced costs of treating infections with SmartSteward. These costs include antibiotics, lab tests and imaging, and isolation when needed. Medicaid patient infection expenses are mostly reimbursed by insurance and are not included. The savings in this 109 bed facility have exceeded $1,200 per month. Further savings are anticipated as the treatment of asymptomatic bacteriuria continues to decrease.
In total, SmartSteward is saving more than 100 hours per month of nursing and IPCO time.
Lower infection rates directly translate to fewer nursing hours dedicated to treating infections. An additional 35 hours per month are now available for patient care and reducing overtime.
More than 300 messages are being sent each month between doctors and nurses. Most of these messages lessen team dependence on lengthy telephone calls and eliminate the frustrations associated with shift changes and missed calls. Improved messaging frees up an additional 25 hours of nursing time each month.
Before SmartSteward, the IPCO spent 40 hours per month collecting data and assembling reports for quality meetings and regulatory reporting. That time can now be reallocated to more productive tasks like improving infection control and educating the nursing team.
The pilot facility is well run and has been averaging five Part A readmissions per month. The initial decline from 24% to 18% indicates there are now at least eight fewer readmissions per year, saving more than $14,000 in bed revenue. Further reductions are expected.
The increased readmissions performance places the facility in a higher percentile among SNFs, which ideally results in significant CMS end-of-year revenue or reduction in penalty.
A low readmissions number is vital to maintaining the CMS star rating, increasing referrals from local hospitals and maintaining an excellent reputation in the community.
The new PDPM payment model, and its impact on SNF revenue, is of concern to all SNF facility and group managers. This new model is shifting resident population away from rehabilitation clients to more post-acute patients. This will increase the need for robust infection control and antibiotic stewardship programs. The PDPM also requires more accurate initial diagnosis and better ICD (International Classification of Diseases) documentation to optimize reimbursement. One of the primary functions of SmartSteward is to assist physicians in accurately diagnosing infections and appropriately treating them with the right dose of the appropriate antibiotic for the optimal amount of time. SmartSteward also helps optimize reimbursement by capturing more accurate ICD information while recording clinical conditions and decisions. The staff at the pilot facility is actively using data from SmartSteward to do just that.
Caring for more clinically complex residents creates increased educational requirements for the entire clinical team. SmartSteward’s prompting provides critical infection-related education to front line nurses as it is needed. Additionally, confidential feedback is periodically shared with doctors to improve prescribing habits and minimize facility resistance.
SNF operators are increasingly concerned about professional liability claims, which include delay in seeking medical treatment, medication error, failure to follow physician orders, failure to move the resident to a higher level of care, failure to treat, and failure to diagnose, among others. SmartSteward captures the entire infection event from the nurse’s initial evaluation and comments, to the doctor’s diagnosis and antibiotic selection, to reassessment after antibiotic therapy begins. This tracking produces a detailed record of every event, which demonstrates diligence in the care a patient receives. This level of detail can be a protective tool with respect to potential liability claims.
These financial and productivity outcomes confirm that automating infection control and antibiotic stewardship using SmartSteward results in significant reductions in expenses and increases in revenue, as well as improved allocation of professional resources.