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A disease management program implemented by nurse case managers helps chronically ill unfunded patients cared for by the North Broward Hospital District avoid hospitalizations and emergency room visits.
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The "yes-means-no" phenomenon was one of several challenges encountered by the team conducting a community case management pilot project for diabetes patients in Nogales, AZ, says Donna Zazworsky, RN, MS, CCM, FAAN, diabetes care center manager for the Tucson-based Carondelet Health Network.
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With studies showing that 10% of patients are using 90% of the nation's health care resources, traditional case management must move to a disease management model, says Bob Whipple, RNC, CCM, CCS, MHA, a Boston-based senior management consultant with ACS Healthcare Solutions.
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With Medicare's stricter reimbursement guidelines and the likelihood that commercial payers will follow suit, it's more important than ever before for patients to move as quickly and safely as possible through the continuum of care, the experts say.
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A simple communication tool used by case management and nursing has decreased the turnaround between when discharge orders are issued and the time the patient is out the door at North Broward Medical Center in Deerfield Beach, FL.
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It took more than 260 days, hundreds of hours on the telephone, and a lot of networking and brainstorming for Chesapeake General Hospital in Chesapeake, VA, to find post-acute care for a seriously ill pediatric patient.
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Reducing readmissions has become an increasingly important goal for hospitals. Medicare is evaluating various payment incentives to encourage lower rates of preventable readmissions.
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Under updated infection control guidelines from the Centers for Disease Control and Prevention (CDC), Standard Precautions now include respiratory/cough etiquette instructions.
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Case managers play a critical role in patient throughput and their voices should be heard whenever hospital staff meet to discuss barriers to admission and discharge and how they can be eliminated, says Charlotte Thompson, RRT, BA, MBA, manager in KPMG LLP's health care advisory practice.
