Ensuring Appropriate Level of Care and Resource Utilisation
How Do You Apply InterQual Criteria?
Using information found in the medical record or supplied by healthcare providers, a care management reviewer determines whether a patient’s clinical status matches the criteria for a specific intervention or placement at a specific level of care. When there isn’t a match, a reviewer or clinical advisor can work with the attending clinician to decide on an appropriate course of action. InterQual will collect this data so that providers and commissioners have the information they need about their local population to configure appropriate beds and services.
While no single tool or process can solve all the challenges facing Trusts today, Evidence Based Medicine empowers Trusts to consistently and efficiently treat patients based on the individual patient’s current conditions.
Programmes such as Referral to Treatment and A&E wait targets were implemented to ensure patients receive appropriate and reasonable access to care in a timely manner. As a result of these programmes and the introduction of the national tariff, providers now recognise more than ever that patients are often being treated at the wrong level of care greatly impacting efficiency and outcomes. Across the country thousands of acute care beds are needlessly filled by patients who would be better served at a lower level of care. The result is a delay in treatment for others which therefore impacts 18 week and efficiency targets.
McKesson’s InterQual® solution has been used by healthcare organisations for over 30 years and uses only the most current, scientifically valid evidence. McKesson’s InterQual solution is the evidence-based clinical decision support tool of choice used in over 5,000 hospitals and other healthcare organisations serving more than 100 million people each day. InterQual’s toolset recommends the appropriate level of care for patients across the healthcare spectrum using evidence based criteria as it relates to an individual patient’s condition. Levels of care covered using InterQual include the many acute care, intermediate care and home and social care levels available. If the appropriate level of care is not achieved based on lack of availability or other factors, InterQual software allows organisations to record these variances and provides the reporting necessary to understand the gap, and aid in the transformation of the care delivery process.
InterQual is not actuarial in its approach. Its effectiveness is centred on symptomology and severity of illness rather than diagnosis – it is a patient-centric solution supporting Lord Darzi’s priorities to ensure that decisions are “locally-led, patient-centred, and clinically driven”.
Used both at the point of care and retrospectively as an auditing tool to enable effective commissioning decisions, InterQual supports clinicians in delivering the appropriate care at the right place and right time!
InterQual has set the industry standard for appropriateness care level recommendations, bringing together the best medical evidence from literature and organises symptoms and clinical indicators in criteria, guideline (including NICE) or white paper format. Where medical evidence is scarce, our expert clinical staff builds consensus with input and validation from members of our consultant panel of over 800 practicing clinicians from across the globe.
...Can you really afford not to utilise InterQual?
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Why has InterQual become the Gold Standard?
InterQual evidence-based clinical decision support criteria has been at the forefront of care management for more than 30 years in the US. Now finally here in the UK, learn about the industry trends that led to the creation of InterQual and what accounts for its longevity and widespread use today in a peer-reviewed article by McKesson’s Dr. Jackie Mitus.