1. Powell, Suzanne K. MBA, RN, CCM, CPHQ

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RED Alert 1

It isn't often that a process comes along that is simple in its elegance and, yet, so intuitively effective. Enter RED!! (Reengineered Hospital Discharge). One of the most critical elements of transitions of care occurs when a patient is discharged from the hospital, and this is where RED is focused. And it is as simple as 1, 2, 3. RED has three components:


1. A nurse discharge advocate, who works with the patient in the hospital.


2. An after-hospital care plan and teach-back methodology.


3. A clinical pharmacist, who calls the patient to reinforce the discharge plan, review medications, and solve problems.



But, as my husband frequently points out to me, "Just because it is simple, doesn't make it easy." Ah yes, the devil is always in the details. Case managers sense that devilish details must occur when a process has outcomes such as a 30% decrease in hospital utilization within 30 days of discharge (Jack et al., 2009). I will let you read these details in this issue's RED article "Preventing the Preventable: Reducing Rehospitalization Through Coordinated, Patient-Centered Discharge Processes."


A recent article highlighting "RED" was published in the Annals of Internal Medicine, and it was quick to point out RED's limitations, specifically, "This was a single- center study in which not all potentially eligible patients could be enrolled, and outcome assessment sometimes relied on participant report" (Jack et al., 2009, p. 178).


Of course, scientific studies must discuss limitations. Professional Case Management (PCM) encourages this discussion when new case management processes have been studied and introduced to our readers. "Limitations" can often mean the difference between truth and, well, maybe the results really are not that generalizable.


If I learned anything when I took a statistics course, I learned that sometimes things are not what they seem. Although I barely remember the difference between a chi-square and a z score, I do remember the gist of one required reading book, How to Lie With Statistics, by Darrell Huff (Huff, 1954). The book outlines common errors, both intentional and unintentional, associated with the interpretation of statistics and how these errors can lead to inaccurate conclusions.


Taking "lying with statistics" to its ultimate absurdity, Dr. Sherman Silber of the Infertility Center of St. Louis talked about the dangers of crackpot correlations. According to Angier (2007), Silber and two other colleagues did a little study with 28 patients with infertility, and I quote:


[They] used a computer program to identify any traits whatsoever, that might link those women who had succeeded in becoming pregnant. Bless my speculum!! What have we here? Those patients whose last names began with "G" "Y" or "N" were significantly more likely to end up bearing a child than their less auspiciously sir-named peers. (Angier, 2007, CD no. 3)


Yes, abuses of statistical methods can involve demonstrating "significance" when clearly none exists. But most of us "know" when something is just not right, like giving a patient with known congestive heart failure intravenous fluids without daily weights, or Donald Trump's hair. The RED process, on the other hand, does feel right, limitations and all, even when applying the rules of clinical common sense. There are some steps that even nonstatistical types can do to "talk back to statistics." Perhaps, the easiest is to ask a simple question: Does this figure, finding, or correlation make sense; is this in accord with what you know about objective reality? (Angier, 2007).


Read this issue's RED article, Google other RED articles, peruse the RED Web site at, download the toolkit, and use some of the lessons in your facility or organization. The worst that can happen is an improved quality of life for one of your charges.


RED Alert 2

The more I ask, the more I realize that many of the Case Management Society of America (CMSA) members and readers of PCM do not know about one of the most valuable perks of their membership and subscription. Did you know that you can research and download, free of charge, any article from PCM back to the year 2000? It is valuable in so many ways: monetarily and for case management, research, and training purposes.


Also, to make your PCM online experience even better, we are transitioning to a new e-journal platform referred to as "myLWW." Readers have told us that they want to read PCM online. There have also been several articles that had important, time-sensitive content that were needed by case managers sooner than we could get them into print (called "Publish Ahead of Print"). This new platform will alleviate these chronic conditions.


Here are a few other changes that you will find on


* New content, such as featured articles and "most viewed."


* New options for article delivery, including an enhanced HTML format for easier reading.


* New ways to customize the site, including saved searches, personal article collections, e-mail and RSS alerts, and more.


* New capabilities, such as exporting references into your favorite citation manager and exporting figures from full-text articles into PowerPoint.


* Publish-Ahead-of-Print articles, important case management announcements, upcoming topics, and supplementary materials.



I will keep you posted on this new platform and more information will be available at the CMSA annual conference in Phoenix. As always, our editorial and production teams are eager to hear your comments and opinions regarding the changes and your needs. Your feedback will be a key part of ongoing research to develop future enhancements.


RED Alert 3

I hope to see you all in Phoenix at the CMSA annual conference this June. Also, a word of caution for those who do not subscribe to AAA (which has an Arizona warning). Arizona highways have more photo radar speed traps than an Arizona State University fraternity house has empty beer bottles on a Sunday morning. So, drive the posted speed limit and may all your flashes in Arizona be flashes of case management insight, not photo radar!!


Have a great time in Phoenix at the CMSA annual conference in June!!




Angier, N. (2007). The canon: A whirligig tour of the basics of science. New York: Houghton Mifflin and Highbridge (audio) Company. [Context Link]


Huff, D. (1954). How to lie with statistics. New York: W.W. Norton. (Paperback reissue, 1993). [Context Link]


Jack, B. W., Chetty, V. K., Anthony, D., Greenwald, J. L., Sanchez, G. M., Johnson, A. E., et al. (2009, February 3). A reengineered hospital discharge program to decrease rehospitalization: A randomized trial. Annals of Internal Medicine, 150(3), 178-188. [Context Link]

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Mission Statement:Professional Case Management is a peer-reviewed, progressive journal that crosses all case management settings. PCM uses evidenced-based articles to foster the exchange of ideas, elevate the standard of practice, and improve the quality of patient care.