Paraplegic (T4-5) secondary to MVA as child; Traumatic Brain Injury; Neurogenic Bladder; Stress Incontinence; Urinary Incontinence; Hypertrophy of breast; Specified congenital anomalies of breast; Intrinsic Sphincter Deficiency; Chronic Urinary Tract Infection; Renal Calculi; Depression


The client was involved in a motor vehicle accident as a child. She suffered from multiple injuries and became a paraplegic from T4-5, as a result of the accident. As a result of her injuries she has had several surgeries and urgent medical needs. This client and family include the MRC Nurse Consultant’s involvement with every detail of the client’s medical care. The MRC Nurse Consultant has been able to ensure the client is seen by PPO providers. When equipment purchases were necessary, the MRC Nurse Consultant presented to the account different pricings demonstrating that the facility was significantly marking up the costs, resulting in negotiations and cost savings. The client and family have been very happy and supportive of the MRC Nurse Consultant and medical case management program sending several messages of gratitude.

Cost Savings:

The MRC Nurse Consultant identified planned care that did not require inpatient hospitalization; therefore the client was able to return home with appropriate care to recover from an outpatient procedure. The cost of care, if inpatient care was instituted, was estimated to be: 7 days for post-operative infection.

Cost Savings: $ 51,483

The MRC Nurse Consultant provided education regarding IV antibiotics that could be given at home or in an outpatient setting. The MRC Nurse Consultant also discussed the importance of hand washing before and after caring for the open wound.

The MRC Nurse Consultant received a message from the client’s father reporting the client’s irrigation tubing began to leak. The MRC Nurse Consultant recommended that the client’s father contact the physician and determine if the tube could be removed and if the client could continue with IV antibiotic therapy. The physician was called the following day and the client was taken in and the irrigation tube was removed. After consulting with provider at the Mayo Clinic, the recommendation was to discontinue the irrigation tube and continue the IV antibiotics. The intervention by the MRC Nurse Consultant avoided an inpatient admission for post-operative wound infection.

Cost Savings: $ 51,483

The MRC Nurse Consultant researched and identified that a wheelchair purchase for the client was marked up 30% and was successful in negotiating a lower cost.

Cost Savings: $ 1,955

Total Cost Savings: $ 104,921