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When Integris Baptist Medical Center in Oklahoma City began looking at implementing palliative care and end-of-life services, the case management department was the appropriate place to start, says Anita Bell, RN, MEd CHPN, palliative care coordinator at the 508-bed facility.
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A systemwide initiative that coordinates care across the continuum for heart failure patients has reduced the 30-day readmission rate for the North Shore-LIJ health system.
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The health care system benefits when unnecessary hospital admissions are avoided, and sometimes the best place to impact that trend is by focusing discharge services on the hospital emergency department (ED), an expert says.
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After three years, Massachusetts General Hospital's Medicare demonstration project to manage the care of high-risk, high-cost Medicare patients appears to be making a difference for many medically complex patients, according to Joanne Kaufman, RN, MPA, A-CCC, nurse manager for the care management program at Massachusetts General.
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Here's a common hospital discharge scenario: the patient is ready to be discharged home, and the hospital has a discharge planner or case manager who is prepared to call the patient's primary care physician (PCP) to discuss the patient's post-discharge care. But who does the discharge planner call? And will anyone respond to the call?
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As part of its efforts to increase transparency in health care and to help consumers make informed decisions about which hospital to choose, the Centers for Medicare & Medicaid Services (CMS) expanded the information on the Hospital Compare website, adding 10 new outpatient measures and updated information on 30-day mortality and readmission rates for heart failure, acute myocardial infarction, and pneumonia.
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In just a few years, your hospital could lose a significant amount of money if its 30-day readmission rate is higher for Medicare patients with certain diagnoses than the rate at other hospitals.
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When a hospital in downtown Knoxville, TN, closed and volume soared at other nearby hospitals, two hospitals in the Covenant Health System joined forces to develop a systematic approach to capacity management that allows each hospital to create variances in the process to meet its individual needs.
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Your ED patient's bad outcome might have nothing to do with the fact that he or she was held in the hallway while awaiting an inpatient bed. However, it could impact the outcome of subsequent litigation against the ED.
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As the Centers for Medicare & Medicaid Services and commercial payers move to base reimbursement on quality and consumers become more savvy about their choices of health care providers, complete and accurate documentation will become even more important.
