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By focusing on discharge on Day 1 and during daily multidisciplinary rounds, Scott & White Healthcare in Round Rock, TX, has maintained an average length of stay for Medicare patients of just 3.2 days and achieved a 30-day readmission rate of just 3%.
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When the Recovery Audit Contractor (RAC) demonstration project began, the RACs began sending out chart requests slowly in the initial months, then increased the volume as the project went on, sometimes issuing requests for as many as 500 records at one time.
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The ED at the University of Kansas Hospital in Kansas City, KS, has virtually eliminated ambulance diversion; there were two diversions in June. It also has reduced its rate of patients leaving without being treated from 12% to 4%.
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The electrocardiogram (ECG) and X-ray of a chest pain patient in his mid-50s were both normal when examined by the treating ED physician. However, the physician's shift ended before the patient's lab results were back.
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Stephen A. Frew, JD, vice president and risk consultant with Johnson Insurance Services, a Madison, WI-based company specializing in risk management for health care professionals, says shift changes or "handoffs" in care often are associated with malpractice claims, typically for these three reasons:
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After the Recovery Audit Contractor (RAC) demonstration project ended, participating hospitals began looking for ways to minimize their risk and resources when the permanent RACs are rolled out.
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Before the Recovery Audit Contractor (RAC) issued its first requests for data, Sharp HealthCare in San Diego assembled a committee of stakeholders to determine what the process would probably be like, how to track requests, how to ensure that the health system responded in a timely manner, and what the appeals process should be.
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When its population of uninsured patients increased as more people lost their jobs, Ingham Regional Medical Center in Lansing, MI, developed a program to provide medication for people who can't otherwise afford it.
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Recognizing that more than half the population with depression is treated in the primary care setting, MercyCare Health Plans developed a depression disease management program focusing on giving primary care physicians the tools they need to be able to recognize and treat depression.
