Stanford Med · Unit 5B Medicine·Day shift·Mon · 9:42 AM

Workflow orchestration

Per-pathway written workflows · Coleman + Naylor + Project RED + IDEAL

For each (disposition × service stack), an ordered, cited workflow of what has to happen, by whom, gated on what evidence. Steps scale by intensity tier — Standard always runs; Elevated and High-risk layer on Coleman / Naylor touchpoints driven by readmission risk.

HOME pathway

Home + CHF discharge bundle

ACC/AHA HFrEF 2022 GDMT initiation + Coleman 4-pillar transition + RPM weights to drive 30-d readmission below the HRRP penalty threshold.

Service stack
  • · Home Health
  • · Remote monitoring
  • · Home DME
  • · Outpatient pharmacy
  • · Outpatient PT / OT
Triggers
  • · CHF (HFrEF or HFpEF) decompensation
Evidence basis
  • · ACC/AHA HFrEF Guideline 2022 §9.4
  • · Coleman CTI (Care Transitions Intervention)
  • · Project RED (Re-Engineered Discharge)
  • · HRRP §3025 ACA
  • · CMS RPM CPT 99453–99458
Outcome metrics
  • · HRRP 30-d CHF readmission (penalty avoidance)
  • · Coleman CTI 30-d rehospitalization ↓~30%
  • · MTM-1 medication reconciliation completion
  • · 7-d post-DC follow-up visit completion
17 of 22 steps at Standard intensity·UB-04 01 (Home / self-care)

Pre-discharge

11 steps
  1. #1T-3d·Hospitalistmedicalgatingstd
    Confirm euvolemic target reached — weight stable ≥24h, BNP/NT-proBNP trending down, no orthopnea or rest dyspnea.

    Premature discharge before euvolemia is the single biggest driver of 30-d CHF readmission. ACC/AHA §9.4.

    ACC/AHA HFrEF Guideline 2022 §9.4·Evidence: Hospitalist 'medically ready' attestation note·Routes via epic_writeback
  2. #2T-3d·Hospitalistmedicationstd
    Initiate / continue 4-pillar GDMT (ARNI or ACE-I/ARB · evidence-based BB · MRA · SGLT2 inhibitor) — start at hospital, titrate as outpatient.

    Hospital is the highest-leverage moment to initiate GDMT. ACC/AHA Class I.

    ACC/AHA HFrEF Guideline 2022 §7·Evidence: Discharge med list shows ≥3 of 4 GDMT classes·Routes via epic_writeback
  3. #3T-2d·Pharmacycost coverageHITLgatingstd
    Submit prior auth for ARNI (sacubitril/valsartan) and SGLT2i if formulary tier 3+; enroll in manufacturer assistance (Novartis Entresto Central, BI Jardiance Patient Assistance) in parallel.

    ARNI + SGLT2i are the highest-impact GDMT additions and the most likely to be PA-denied. Parallel manufacturer-assist enrollment removes the affordability cliff.

    CMS-0057-F (PA streamlining) + Novartis/BI PAP programs·Evidence: PA approval letter OR manufacturer-assist enrollment confirmation·Routes via covermymeds
  4. #4T-2d·Hospitalistcost coveragegatingstd
    F2F encounter note completed and signed — required for both Home Health (42 CFR §424.22) and Home DME scale/O₂ (42 CFR §410.38).

    Missing F2F is the #1 reason HH start-of-care visits delay or get denied. One note covers both services.

    42 CFR §424.22 + 42 CFR §410.38·Evidence: F2F note signed within HH eligibility window·Routes via epic_writeback
  5. #5T-2d·Case ManagerresourcesHITLgatingstd
    Place HH agency referral with CMS-485 plan of care elements; warm-handoff phone call to receiving HH RN.

    Start-of-care visit must occur ≤48h after discharge — referral has to be in the agency's queue before the patient leaves the bed.

    42 CFR §424.22 (HH conditions of participation)·Evidence: HH agency bed-hold / SOC-visit confirmation·Routes via naviguide
  6. #6T-2d·Case ManagerresourcesHITLstd
    Order RPM bundle — connected scale + BP cuff + pulse-ox; confirm vendor delivery window ≤72h post-DC.

    Daily weight is the single most sensitive predictor of impending readmission. Without RPM, decompensation is invisible until ED.

    CMS RPM CPT 99453/99454/99457/99458; AHA scientific statement on telemonitoring·Evidence: RPM vendor delivery confirmation·Routes via rpm_vendor
  7. #7T-2d·Case Managerresourcesstd
    Order Home DME (bathroom scale if not in RPM bundle; walker if mobility limited; O₂ concentrator if SpO₂ <88% on RA).

    DME delivery is a frequent same-day-of-DC delay driver. Order ≥48h ahead.

    42 CFR §410.38 (DMEPOS F2F + 6-month rule)·Evidence: DME supplier delivery slot booked·Routes via epic_writeback
  8. #8T-1d·Pharmacymedicationgatingstd
    Discharge medication reconciliation with teach-back — patient/caregiver verbalizes purpose, dose, timing, and warning signs for each of the 4 GDMT classes.

    Coleman Pillar 1 (medication self-management). Reconciliation without teach-back fails — Project RED component 5.

    Coleman CTI Pillar 1 + Project RED Component 5 + AHRQ Teach-Back Toolkit·Evidence: Pharmacist teach-back completion note + patient self-rated understanding·Routes via epic_writeback
  9. #9T-1d·RNpatient agreementgatingstd
    Deliver red-flag education with teach-back: daily weight gain ≥2 lb overnight or ≥5 lb in a week, increased dyspnea, orthopnea, swelling — call HF clinic, not 911 (unless severe).

    Coleman Pillar 4 (red-flag knowledge). Patients who can name their warning signs have ~25% lower 30-d readmit.

    Coleman CTI Pillar 4 + AHA Get With The Guidelines HF·Evidence: RN red-flag teach-back note + patient verbalized 3 warning signs·Routes via epic_mychart
  10. #10T-1d·Case Managerpatient agreementgatingstd
    Book 7-day post-DC transition-of-care visit with cardiology / HF clinic OR PCP; confirm appointment in patient's calendar + portal.

    Coleman Pillar 3 (follow-up). HRRP-tracked: 7-d follow-up reduces 30-d readmit by ~20%. Bills as CPT 99495/99496.

    Coleman CTI Pillar 3 + CPT TCM 99495/99496 (CMS)·Evidence: Appointment confirmed within 7d in EHR + portal·Routes via epic_mychart
  11. #11T-1d·Patient / Caregiverpatient agreementstd
    Confirm preferred pharmacy + delivery address + caregiver phone in MyChart preference form; review the After-Visit Summary with case manager.

    Coleman Pillar 2 (dynamic PHR). Family decision-lag is the #1 cause of avoidable same-day delays at discharge.

    Coleman CTI Pillar 2 + IDEAL Discharge Planning (AHRQ)·Evidence: Preference form submission timestamp·Routes via epic_mychart

Day of discharge

3 steps
  1. #12Day of DC·Pharmacymedicationgatingstd
    Meds-to-beds delivery — all GDMT scripts dispensed bedside before transport.

    Patient leaving without meds in hand = ED return within 7d in ~12% of CHF discharges.

    Project RED Component 6 (medications-to-bed)·Evidence: Meds-to-beds delivery signature·Routes via voalte
  2. #13Day of DC·RNmedicalstd
    Final pre-discharge vitals + weight; record baseline for RPM trending.

    RPM weight trending needs a verified baseline at discharge — otherwise the first home reading reads as a swing of unknown direction.

    AHA Scientific Statement on Remote Monitoring in HF·Evidence: Discharge vitals + weight in EHR·Routes via epic_writeback
  3. #14Day of DC·Case Managercost coveragestd
    Write UB-04 Patient Discharge Status Code 01 (Home) to encounter; close all open referral loops.

    Encounter billing closes once UB-04 is set. Open referral loops = audit risk.

    NUBC UB-04 Patient Discharge Status Code list·Evidence: UB-04 01 on encounter·Routes via epic_writeback

Post-discharge

3 steps
  1. #15T+2d·Vendormedicalgatingstd
    Home Health start-of-care RN visit; verify med adherence, weight today, edema, dyspnea, fall safety.

    SOC visit ≤48h is a CMS HH condition of participation. Catches early decompensation.

    42 CFR §484.55 (HH comprehensive assessment)·Evidence: HH SOC OASIS assessment in EHR·Routes via epic_writeback
  2. #16T+3d·VendormedicalHITLstd
    RPM data review — flag any weight gain ≥2 lb/24h or ≥5 lb/week; escalate to HF clinic via Voalte.

    First 72h post-DC is the highest-risk window for fluid re-accumulation.

    ACC/AHA HFrEF 2022 §9.4 + CMS RPM threshold guidance·Evidence: RPM dashboard review note·Routes via voalte
  3. #17T+7d·PCP / Follow-up MDmedicalgatingstd
    Transition-of-care visit — review hospital course, titrate GDMT, repeat BMP + BNP, reconcile meds, confirm RPM adherence. Bill TCM CPT 99495 (or 99496 if high complexity within 7d).

    Coleman Pillar 3 + HRRP-tracked metric. 7-d visit is the highest-leverage post-DC touchpoint.

    Coleman CTI Pillar 3 + CPT 99495/99496·Evidence: TCM visit note with billed CPT 99495/99496·Routes via epic_writeback
Demo data · no PHI · mocked Epic + payer endpoints