title: Substitution of hospital staff in concurrent utilization review.
abstract: Substitution of hospital staff performing concurrent utilization review (CUR) was evaluated using a production process framework. There were no differences in the number of reimbursement denials or denied days among 4 job classifications of hospital staff performing CUR, indicating that educational preparation of staff did not affect outcomes. The implications are that hospitals could substitute assistive staff in place of registered nurses to complete the CUR function, potentially increasing the availability of professional nurses.
authors.affiliation: Clinical Science Center, School of Nursing, University of Wisconsin-Madison, Madison, WI 53792, USA. jvdarmody@wisc.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Darmody
authors.forename: Roberta
authors.initials: R
authors.lastname: Pawlak
authors.forename: Mary
authors.initials: M
authors.lastname: Hook
authors.forename: Yulia
authors.initials: Y
authors.lastname: Semeniuk
authors.forename: Judith
authors.initials: J
authors.lastname: Westphal
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Murray
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Henriques
mesh_terms: D000046:Academic Medical Centers; D000704:Analysis of Variance; D019090:Case Management / Q000458:organization & administration*; D016009:Chi-Square Distribution; D003211:Concurrent Review / Q000458:organization & administration*; D004496:Education, Continuing; D004500:Education, Graduate; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D015146:Midwestern United States; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D011361:Professional Competence / Q000592:standards; D024382:Professional Role; D015397:Program Evaluation; D012189:Retrospective Studies; D012456:Salaries and Fringe Benefits; D012947:Social Work / Q000193:education / Q000458:organization & administration*