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As the Centers for Medicare & Medicaid Services (CMS) Value-Based Purchasing program moves toward basing reimbursement on quality, case managers can take the lead in making sure their hospitals score well and dont lose reimbursement.
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Gundersen Healths integrated care coordination program, in which a team of RN care coordinators and social workers follows the 1% to 2% most complex patients through the continuum, has resulted in a 46% decrease in average length of stay and a 64% decrease in unplanned hospital admissions or emergency department visits.
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A proactive approach to the Recovery Auditor (RA) process has paid off for Alamance Regional Medical Center in Burlington, NC. Out of more than 800 denials from the auditor, the hospital has appealed up to the administrative law judge level, if necessary. So far, the hospital has won a high percentage of the appeals. Many are still pending because of a backlog.
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When doctors, nurses, and other hospital operating room staff follow a written safety checklist to respond when a patient experiences cardiac arrest, severe allergic reaction, bleeding followed by an irregular heartbeat, or other crisis during surgery, they are nearly 75% less likely to miss a critical clinical step, according to a new study funded by the Agency for Healthcare Research and Quality (AHRQ).
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Of the hundreds, if not thousands, of patient safety strategies employed at hospitals across the country, the Agency for Healthcare Research and Quality (AHRQ) has released a report identifying the top 10 patient safety strategies that can be implemented immediately by healthcare providers.
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No one wants to see the ED used inappropriately, but it can be particularly frustrating when patients keep coming back with problems that never seem to get resolved.
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In the wake of the horrific massacre of young children by a disturbed gunman at Sandy Hook Elementary School in Newtown, CT, there has been a national discussion about what the country can do to curb such senseless acts of violence.
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For the past few years, the ED at St. Mary Medical Center in Langhorne, PA, has seen double-digit increases in patient volume. The surging demand has been difficult, to say the least. And by early 2012, administrators realized it was time for a change in course.
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Sometimes an IRB director will notice that board members lack interest in evaluation processes. Any attempt to assess how each member is doing might be shuffled to the back burner of the schedules of very busy people.
