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Georgene Siemsen, MS, RN, GNP-BC, visited the home of a 74-year-old patient at Bend (OR) Memorial Clinic because of concerns that she was not refilling her medication consistently. Inside, Siemsen found a disorganized collection of old bottles, expired prescriptions, and multiple refills of the same medications.
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When the Bend Memorial Clinic receptionist offered a 90-year-old patient a brochure describing the clinic's medical home model and a letter introducing the nurse care management program, the patient angrily threw the materials back.
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When patients who have a high risk of rehospitalization are discharged from Bayada Home Health Care's home health services, the Mooretown, NJ, home health company calls them monthly for the next year to find out how they are feeling and whether they need assistance or additional services that will help them avoid another hospital admission.
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As a result of a patient-centered medical home pilot program based around preventive and coordinated care, Bend (OR) Memorial Clinic's hospital admissions and emergency department visits dropped for Medicare Advantage members of PacificSource Health Plans.
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Lack of reporting of infectious disease exposures may also result in a lack of treatment. And that can have serious, even deadly, consequences.
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When upfront collections first became a focus several years ago at Portland, OR-based Legacy Health’s six hospitals, “we started with the basics,” says Lindsay Hayward, director of patient access and health information management.
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The history of cardiac arrest as an indication for resuscitation is "loaded with implications for current standards of care," says Daniel Brauner, MD, associate professor of medicine at the University of Chicago. At one point in time, resuscitation was used only in very limited instances, he explains.
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The evolution of "transplant tourism" drives home the point that people are willing to go to extreme lengths to procure an organ, according to Leslie M. Whetstine, PhD, an assistant professor of philosophy at Walsh University in North Canton, OH. "Despite the fact that the public overwhelmingly supports organ donation in this country, our actions unfortunately do not reflect that sentiment," she says.
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Approximately one in five (22%) out of 608 critical care physicians surveyed reported always providing surrogates of critically ill adult patients with a recommendation about limiting life support, while one in 10 (11%) reported rarely or never doing so, according to a just-published study.1 Surrogates' desires for recommendations and physicians' agreements with surrogates' likely decisions may influence whether recommendations are provided.
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Linking payment to patient satisfaction could have a profound impact on the doctor-patient relationship, argues James N. Kirkpatrick, MD, an assistant professor of medicine at the Hospital of the University of Pennsylvania who is affiliated with the University of Pennsylvania Department of Medical Ethics and Health Policy.
