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If youre not involved when your hospital contracts with managed care companies, you may miss an opportunity to eliminate denied or avoidable days and maximize reimbursement.
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Park Nicollett Health Services (PNHS), a health care system based in St. Louis Park, MN, has demonstrated savings of $7.5 million in 2004 as the result of adopting the Toyota Production System also known as Lean Production. The systems success stories include:
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An emergency department patient is brought in for an X-ray, but the nurse forgets to tell the radiologist about the patients allergy to contrast dye. During a change of shift, a caregiver doesnt mention that the patient is at high risk for a fall injury.
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An increasing number of one-day stays and patients who failed to meet admission criteria formed the impetus for a throughput initiative that is reducing inappropriate admissions at Sutter Health in Sacramento, CA, says Barbara Leach, RN, director of case management for Sacramento Yolo Sutter Health.
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When Jackson Health System in Miami started its first hospital-based disease management program in 1995, the case management department was able to show that the hospital saved $5 for every dollar the hospital spent on case managers in the disease management program.
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Drawing on 20 years of quality improvement experience, MPRO, Michigan's Health Care Quality Improvement Organization, is bringing together hospitals, home health agencies, and physician practices to come up with solutions to communications barriers between providers, with the ultimate goal of improving the outcomes for the state's cardiovascular disease patients.
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An initiative that assigns ownership of HEDIS®* measures to various staff members has resulted in improved HEDIS scores and national acclaim for Keystone Health Plan Central, a wholly owned subsidiary of Capital BlueCross, independent licensees of the Blue Cross Blue Shield Association.
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An estranged husband comes into the house while the home health nurse is teaching the patients mother how to do enteral therapy as he begins physically abusing the mother, he looks at the nurse and says, Youre next.
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As increasing numbers of older Americans spend their last days in a nursing home, its important for nursing home staff, as well as hospice providers, to identify nursing home patients who might qualify for a hospice placement, an end-of-life care expert says.
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One in three (33%) U.S. adults who have been prescribed drugs to take on a regular basis reported that they often or very often are noncompliant with the treatment regimen, according to a recent Harris Interactive on-line survey.
