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Predictive modeling is an invaluable tool in early identification of people who can benefit from case management, but using the score alone doesnt go far enough, says Kay Sherwin, RN, CCM, director of client services for Integrated Healthcare Information Services (IHCIS), a Waltham, MA-based predictive modeling and information solutions firm.
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A perception gap often exists today between what health care providers say, prescribe, and advise, and what patients actually understand and carry out in their self-care. Many factors can influence this gap, including a lack of language comprehension. Yet, even when a patient is well educated, highly conversant, and appears to understand what the health care provider is saying, a perception gap can result.
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A clinical redesign project partnering social work and case management has resulted in a 15% drop in length of stay and a 66% reduction in denials during a period when the average number of cases increased by 24% at Childrens National Medical Center in Washington, DC.
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One of the better known ongoing collaborations in the United States is the Cambridge, MA-based Institute for Healthcare Improvements (IHI) 100,000 Lives Campaign, whose goal is to save 100,000 lives through targeted QI interventions by June 14, 2006.
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The authors of this issue point out that 3-11% of malpractice dollars paid are disbursed for wound-related cases. Although wound infections may occur despite proper wound care, the detection of tendon or nerve injuries as well as joint violations requires a higher index of suspicion. This months review of wound management and its pitfalls serves the reader well by keeping the practitioner attentive to the potential problems of wound care.
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