Managing variances in case management.

Timely management of variances is vital for cost effective patient care. A multifaceted approach that involves the healthcare team, patient, and family facilitates the identification and management of variances as they occur. The critical path can be used to monitor variances that influence fiscal outcomes in select patient populations. Strategies are described that can be used to monitor and manage variances, including developing a mechanism for monitoring and managing variances, implementing that mechanism, and evaluating the process for usability. Monitoring variances includes choosing tools that will be used and staff who will assume primary responsibility, and initiating an outcome analysis program. Managing variances comprises organizing an interdisciplinary committee, establishing a communication plan, creating strategies, and using continuous quality improvement teams.