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Now that the permanent Recovery Audit Contractor (RAC) program has gone into high gear, hospitals can lessen their vulnerability to losing revenue if they know how to respond and what to expect, says Deborah Hale, CCS, president of Administrative Consultant Services LLC, a health care consulting firm based in Shawnee, OK.
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As a case manager on the congestive heart failure unit at Danbury Hospital, Karen Morgan, RN, MSN, CCM, RN-BC, often manages the care of elderly patients.
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As Karen Morgan, RN, MSN, CCM, RN-BC, makes rounds with the rest of the treatment team on Danbury Hospital's heart failure unit, she uses her knowledge as a certified gerontology nurse to point out the special considerations that the elderly patients on the unit may need.
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Every summer The Joint Commission issues a list of those standards hospitals find most difficult to comply with. Among those challenging standards are three that experts say most directly impact the ED:
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Analyze the data in your hospital's Program for Evaluating Payment Patterns Electronic Report (PEPPER) to identify areas where your hospital may be vulnerable to denials from the Recovery Audit Contractors (RACs), suggests Deborah Hale, CCS, president, Administrative Consultant Services LLC, a Shawnee, OK, health care consulting firm.
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By developing a case management model that frees RN case managers to do what they do best coordinate care Fauquier Hospital in Warrenton, VA, has reduced its average length of stay without affecting the readmission rate.
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Aggressive fluid resuscitation, which normally would be used in younger trauma patients, potentially could do serious harm to an elder patient, warns Rhyan Weaver, RN, BSN, CEN, clinical supervisor in the ED at St. Joseph's Hospital and Medical Center in Phoenix, AZ.
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In the Planetree model, staff don't treat patients like they'd want to be treated. Instead, they find out how the patient wants to be treated, says Linda Sharkey, RN, MSN, vice president of patient care services and chief nurse executive at Fauquier Hospital.
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There are any number of reasons why an ED and its hospital would have difficulty complying with The Joint Commission standard regarding egress, says Diana S. Contino, RN, MBA, FAEN, senior manager of health care with Deloitte Consulting in Los Angeles.
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Initial data on the use of cell phone photos of injuries, taken by the patients themselves in the ED at The George Washington University Hospital in Washington, DC, offers the promise that they might have the potential to speed treatment without sacrificing diagnostic accuracy.
