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A patient readiness scoring system that arose out of the tragedy of 9/11 has served as an effective way to address throughput, as well as an emergency preparedness tool, says Dee Page, RN, director of case management for Virtua Memorial Hospital of Burlington County in Mount Holly, NJ.
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Are the terms discharge planning and case management interchangeable, or are they distinct, and is there a place for both in todays health care environment?
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At Medical City Dallas Hospital, case managers and social workers tailor their discharge planning and education around the patient and familys cultural beliefs, particularly when end-of-life issues are involved.
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By using the hospitals on-site interpreters when they make assessments of patients who dont speak English, case managers at Boston Medical Center are able to start the discharge plan early in the stay and identify resources in the community that provide services for people of different religions and ethnic backgrounds.
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In an effort to spur documentation, standardize teaching, and ensure patients will be ready for a safe discharge, many institutions utilize checklists, guidelines, and teaching plans. However, the implementation of these tools doesnt necessarily guarantee the desired result will be achieved.
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A new, innovative medical management program by Blue Cross and Blue Shield of Illinois helps members take charge of their own health by providing interactive tools and information about health conditions, including opportunities to e-mail a nurse care advisor, personal trainer, registered dietitian, or health coach and get an answer back within one business day.
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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.
