Keywords

concurrent review, hospital costs, personnel management, utilization review

Authors

1. Darmody, Julie MSN, APRN,BC
2. Pawlak, Roberta MS, RN
3. Hook, Mary MS, APRN,BC
4. Semeniuk, Yulia MS, RN
5. Westphal, Judith MSN, RN
6. Murray, Mary Ellen PhD, RN
7. Henriques, Jeffrey PhD

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.