Feedback Memo

  Directions: Are you able to clearly identify the problem and the cause? What suggestions and comments do you offer to add greater clarity? Provide suggestions as to how the symptoms and effects can be clarified, qualified or quantified. DO NOT COMMENT ON ANOTHER STUDENT’S PROBLEM STATEMENT IF THEY HAVE ALREADY RECEIVED COMMENTS FROM ANOTHER CLASSMATE.  Finally, take the feedback you receive for further revision of your symptoms and effects. 
Problem Statement: VITAS Healthcare in Broward is losing money due to late referrals of hospice patients who die before admission. 
Symptoms of the Problem
The executive team at VITAS Healthcare in Broward is very concerned as there is a 10% increase in the number of patients referred, however, the admissions have decreased by 5%. The result led to a decrease in the monthly patient care revenue of 142,912.50. Physicians are referring patients, but they refer too late when patients at facing their last hours or minutes of life. Therefore, the patients are dying before admission to hospice.
Cause of the Problem
Despite the benefits in hospice care and the increasing referrals to hospice, there are many patients still being referred too late.  When physicians are uncomfortable in discussing the patient’s prognosis or lack the understanding of hospice, late referrals are the result. When physicians are confident in their ability to have the difficult conversation with patients and families, referrals to VITAS Healthcare will result in appropriate patients admitted and an increase in patient care revenue to the desired monthly patient revenue goal of $142,912.50.
Effects of the problem
The decrease in the timely referral and admission of appropriate patients and the decreased patient care revenue have affected the program and the patients in many ways. The program presently has 47 admissions staff on the admissions team including two managers, forty nurses and five program schedules. The Admissions Labor dashboard which highlights the productivity of the staff shows that ten nurses are struggling and only admitting one or no patient daily. Likewise, three of the program schedulers appear to be busy following up to schedule families for admission appointments while two schedulers are unproductive with only a few calls daily.
The decrease in patient revenue has caused a negative bottom line in the income from operations.
Late referrals resulting in pts dying before admissions to hospice robs the patients of their hospice benefit of ending their life in dignity and receiving therapeutic comfort care