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While the Centers for Disease Control and Prevention (CDC) in Atlanta has been calling on EDs to routinely test patients for HIV since 2006, the practice is hardly widespread.
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If a health system wins a major national quality award, it must be doing something right, but also something different from other organizations, right? Ask one and likely at some point, a spokesperson will says something about focusing on the patient and striving to improve. But not everyone.
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For some patients, particularly senior citizens, the hospital can be like a revolving door. They're in and out of the hospital frequently, despite the best efforts of clinicians to keep them healthy in the community.
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An integrated approach to managing the care of Medicare Advantage members with special needs has paid off for Baltimore-based XLHealth, resulting in increased primary care interventions and reduced rates of hospitalization and emergency department visits.
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Under-triage, or assessing patients as being less ill than they actually are, can lead to treatment delays and adverse outcomes, including serious injury and even death. Despite such dire consequences, however, Lisa Wolf, PhD, RN, CEN, FAEN, a clinical assistant professor nursing at the University of Massachusetts in Amherst, MA, believes that under-triage is occurring in ED environments across the country.
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Perhaps the saddest thing about the Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report, released in February by the Agency for Healthcare Research and Quality (AHRQ) is not that so many people believe the culture in their hospitals is an impediment to error reporting, but that so many people who work in the patient safety arena are not surprised at the high number of people responding that way.
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To help frail Medicare Advantage members with multiple medical problems live independently at home, Independent Health Association in Buffalo, NY, works with Family Choice, a care management provider, to arrange home visits. During visits, they educate members about their healthcare conditions and treatment options, discuss medication, and arrange for needed services.
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At the Open Door Medical Center, a community health center in Ossining, NY, embedded case managers work with patients infected with HIV, helping them navigate the healthcare system and get the medical care and other assistance they need to keep their condition under control.
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A proactive approach to engage at-risk members before they have an adverse medical event is paying off for CareFirst BlueCross and Blue Shield, a Baltimore-based health plan.
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When an interdisciplinary team including patient access, insurance verification, and radiology personnel was formed to reduce claims denials, "realizing where denials are coming from was definitely our first step," reports Brian A. Todd, CHAM, manager of patient access staff development and training at Lourdes Health System in Camden, NJ.
