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Configuring Level of Care Groups

Note: Your Staff Manager configuration may not include this optional application. To add this application to your configuration, contact your Clinical Consultant or Client Advocate.

As mentioned in Patient Pattern Management Terms Explained, Level of Care Groups are one or more nursing units defined as like units based on the relative intensity of service or nursing care provided. Each nursing unit may be associated with one level of care group. Demand Manager uses level of care groups to define the length of stay by type of unit in criteria-based patient progress patterns.

You can only have 10 Level of Care groups at any one time. To create a new group after reaching the maximum number of 10, you must first delete an existing group. Be aware, however, that you cannot delete any Level of Care group that has patient data connected with it.

To avoid confusion when analyzing Level of Care data, Cerner strongly recommends that organizations take the following steps.

• Establish a naming convention for Level of Care groups that keeps the group names consistent across facilities. For example, avoid having a Level of Care group named MedSurg in one facility, while the same group is named Routine in another facility. Such inconsistencies limit analysis for clients who are part of multi-facility organizations.
• Establish a naming convention for Level of Care group abbreviations that keeps abbreviations consistent across facilities. This provides consistency when analyzing level of care data in Patient Progress Manager reporting.
• When multiple facilities each have the same level of care groups identified for them, Cerner recommends that the Care Level Values remain largely consistent as well.
• Review and apply the best practices for configuring Level of Care groups.

Adding a Level of Care Group

Complete the following steps to add a level of care group:

1. From the Configure menu, select Demand Manager> Level of Care Groups. This opens the Level of Care Groups page. The Group Details tab is active by default.
2. In organizations with multiple facilities, the page displays a Facilities menu in the Navigation pane. Select a facility from the menu.
3. Click the Add link in the green menu bar. The words new group are displayed in the (Care Level) Groups box and the Name and Abbreviation boxes are highlighted in the right pane.
4. Enter a name for the new group, such as Critical Care.
5. Enter an abbreviation for the new group, such as CC. Keep the abbreviation as short as possible, as it displays in the patient's pattern bar. Abbreviations of 2 or 3 characters are optimal. Positioning your pointer over a Level of Care Group abbreviation in the Groups box reveals the group's full name in a tooltip.
6. Select a Care Level Value from the menu. A Level of Care Group can have only one Care Level Value at a time. Available values include 1 through 10, with 10 representing the highest or most intense care level needed (relative to all units) and 1 representing the lowest or least intense level. For example, you might assign a Critical Care group a Care Level Value of 10, an Intermediate Care group a value of 7, and a Routine Care group a level of 4. The page displays these values beside the group abbreviation in the (Care Level) Groups box. You use these values to determine if patients with stays that include time on more than one level of care are progressively moving to less acute levels of care or if they are regressing to higher levels of care. See Best Practices for Configuring Level of Care Groups for more information about setting Care Level Values.
7. If you want, you can select Hide from List. Selecting this check box removes the group from the Level of Care Group list on the Progress Patterns configuration page, meaning no one can use it for future progress pattern configuration. A Level of Care Group can be hidden, rather than deleted, when patient data is connected with it. Hiding a group does not remove any assigned locations from the group.
8. Configure the Length of Stay (LOS) alerts. The Patient Pattern Management page alerts you when patients reach different points in their level of care LOS. You determine when these alerts are displayed by entering the percentage of level of care LOS needed to trigger the alerts in the Show Alert when Length of Stay section. You only need to enter the start percentage for each range; the start of the next range determines the stop for the preceding range. The three sets of LOS alert limits are:
   1. Approaches Limits: The default Start value is 80%.
   2. Meets Limits: The default Start value is 90%, making the default Stop value for the Approaches limit also 90%.
   3. Exceeds Limits: The default Start value is 105%, making the default Stop value for the Meets limit also 105%. There is no Stop value for the Exceeds limit.
9. Click the Assign Locations tab to connect locations to the new level of care group.
10. Select an effective date from the New Date list, or select a new future date using the date menu.
11. Select locations from the Available Profiles/Locations box. Each level of care group must have at least one assigned location.
    1. Select the profiles or locations or both. Each location can belong to only one level of care group at a time. If a location has already been assigned to a group, that location is displayed in gray with the current group abbreviation beside it in parentheses. For example, if 6N MedSurg is assigned to the Routine level of care group, the page displays it the Available Profiles/Locations box as 6N MedSurg (ROUT). You would need to remove 6N MedSurg from the Routine group before you could assign it to another group.
    2. Click Add to move the selected items to the Selected Profiles/Locations box.
12. Click Save. This opens a confirmation pop-up window.
13. Click OK.

Editing a Level of Care Group

Complete the following steps to edit a level of care group:

1. From the Configure menu, select Demand Manager> Level of Care Groups. This opens the Level of Care Groups page.
2. In organizations with multiple facilities, the page displays a Facilities menu in the Navigation pane. Select a facility from the menu.
3. In the (Care Level) Groups box, select the group you want to edit.
4. Edit the group using the options on the Group Details tab and the Assign Locations tab.
5. Add locations to the Selected Profiles/Locations grid.
   1. Locations can belong to one location group at any point in time; gray text and the location group abbreviation in parenthesis indicates the location is already associated with a group. You have to remove the location association before you can assign it to another level of care group. A location can be associated with one level of care for a future date.
6. Click Save. This opens a confirmation pop-up window.
7. Click OK.

Changes to a level of care group abbreviation, name, care level, and alert percent ranges do not require a new effective date. These changes are effective immediately.

Deleting a Level of Care Group

You cannot delete a level of care group if any of the following conditions are true:

• The group is currently assigned to a progress pattern. You would need to first remove the group from the progress pattern before deleting it.
• The group was assigned to a progress pattern.
• The group was assigned to a patient encounter.

If the group has data connected with it, you cannot delete it, but you can hide it. See the following section Hiding a Group from List.

Caution: Deleting a level of care group cannot be undone. Be careful when deleting level of care groups.

1. From the Configure menu, select Demand Manager> Level of Care Groups. This opens the Level of Care Groups page.
2. In organizations with multiple facilities, the page displays a Facilities menu in the Navigation pane. Select a facility from the menu.
3. In the (Care Level) Groups box, click the group you want to delete.
4. Click the Delete link in the green menu bar. This opens a confirmation pop-up window.
5. Click OK to confirm the group deletion.

Hiding a Group from the List

If a level of care group has been assigned to a pattern with patient data, it cannot be deleted. Instead, you can hide the group. Hiding the group removes it from the Level of Care Group list on the Configure Progress Patterns configuration page for future patterns. Hiding a Level of Care Group does not remove the locations assigned to the group; you need to remove the locations assigned to the group if those locations need to be assigned to other level of care groups.

1. From the Configure menu, select Demand Manager> Level of Care Groups. This opens the Level of Care Groups page. The Group Details tab is active by default.
2. In organizations with multiple facilities, the page displays a Facilities menu in the Navigation pane. Select a facility from the menu.
3. In the (Care Level) Groups box, select the group to be hidden.
4. Select Hide from List.
5. Click Save. This opens a confirmation pop-up window.
6. Click OK.

You can click Reset to undo any edits made since you last saved the configuration.

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