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Instead of thinking of case management as a hospital model, start thinking about case management as a continuum model, which transcends where people receive care, advises Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and partner and consultant in Dallas-based Case Management Concepts.
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In the Inpatient Prospective Payment System (IPPS) proposed rule, the Centers for Medicare & Medicaid Services reiterates its intention to shift Medicare reimbursement from a system based on volume to one based on quality of care.
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If you haven't expanded your readmission reduction projects beyond heart failure, pneumonia, and acute myocardial infarction, your hospital may find itself with reduced reimbursement in the future, warns Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and partner and consultant in Dallas-based Case Management Concepts.
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Memo to the Centers from Medicare & Medicaid Services (CMS) from two leading surgeons on the literal cutting edge of infection prevention in the OR: Hospitals and federal regulators should encourage the use of newer and safer types of surgery and more transparency with patients on procedure options and possible outcomes. That would do more to reduce surgical site infection (SSI) rates than inspections by CMS and other government regulators.
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As the lines blur between patient safety and worker safety, employee health professionals including those "two-hat" infection preventionists with dual responsibilities can expect much more scrutiny from regulators who traditionally focused on patient care.
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Recently I've chosen a major change in job responsibilities. For the second time I'm the sole Infection Preventionist (IP) for a facility, but this time the realm of 'Quality' is included, and my facility is a 32-bed surgical hospital including a four-bed ICU. It was time to challenge myself to keep learning new approaches to age-old problems surrounding patient safety. Talk about moving out of the comfort zone!
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The Centers for Medicare & Medicaid Services (CMS) continues to develop an infection control survey slated for use in the nation's hospitals later this year, using expert feedback and "pre-testing" results from the field to create a 42-page tool that assesses a wide breadth of program issues.
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The Veterans Health Administration has developed best practices in handling large-scale epidemiologic look-back investigations, including finding a way to explain a potential exposure of blood-borne viruses to a large number of people who likely were not impacted by the incident.
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