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By placing on-site nurse case managers in hospitals and post-acute facilities, Presbyterian Health Plan of New Mexico has saved more than $1 million in just 10 months, according to Paula Casey, MSN, RN, ONC, CCM, clinical director for inpatient and recovery services at the Albuquerque-based health plan.
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WellPoint's initiatives to reduce hospital readmissions by following up with Medicare Advantage members after discharge has decreased the readmission rate and reduced skilled nursing days, according to Karen Amstutz, MD, vice president and medical director of care management for seniors and state sponsored business for the Indianapolis-headquartered health benefits company.
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The first year after Piedmont Hospital in Atlanta implemented a Heart Failure Resource Center that provides care coordination for patients discharged with heart failure, the 30-day rehospitalization rate for heart failure patients in the program decreased from 4.6% to 1.6% when compared to heart failure patients treated at Piedmont and not in the program.
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Thirteen rural hospitals in the state of New Hampshire decided several years ago to pool the funding of each hospital's Small Rural Hospital Improvement Grant Program (SHIP) funds to create a network for a QI initiative called the New Hampshire Critical Access Hospital, Quality Improvement Network (QIN).
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Spectrum Health, based in Grand Rapids, MI, has introduced a successful patient safety program called "Condition Concern" that its proponents say offers a unique approach to patient and family involvement in expressing concerns they have about care. The program was described in a recent article in the Journal of Nursing Care Quality.
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A recent federal report that included the highly publicized finding that some 15,000 Medicare patients die every month due to adverse events and hospital-acquired conditions (HAC) may ratchet up pressure on hospitals to prevent infections, which represented some 15% of the HACs.
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Amid the successes in sharps safety in hospitals in the 21st century, there is one glaring gap: the operating room. Sharps injuries there remain as much of a problem as they were in 2000, when the Needlestick Safety and Prevention Act was signed into law.
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The patient asks, "Is it safe to take?" You pause, thinking, the FDA classifies it as a Category C, and everybody seems to use it, but how can anybody be sure? So, you finally respond, "It has been used a lot in pregnant patients and no harmful effects have been observed." But, you say to yourself, am I really confident? What would I do for myself or my spouse if in the same situation?
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A team-oriented approach to working with members with non-healing wounds has paid off for UPMC Health Plan and its network providers.
