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For some patients, particularly senior citizens, the hospital can be like a revolving door. They're in and out of the hospital frequently, despite the best efforts of clinicians to keep them healthy in the community.
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An integrated approach to managing the care of Medicare Advantage members with special needs has paid off for Baltimore-based XLHealth, resulting in increased primary care interventions and reduced rates of hospitalization and emergency department visits.
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Under-triage, or assessing patients as being less ill than they actually are, can lead to treatment delays and adverse outcomes, including serious injury and even death. Despite such dire consequences, however, Lisa Wolf, PhD, RN, CEN, FAEN, a clinical assistant professor nursing at the University of Massachusetts in Amherst, MA, believes that under-triage is occurring in ED environments across the country.
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Perhaps the saddest thing about the Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report, released in February by the Agency for Healthcare Research and Quality (AHRQ) is not that so many people believe the culture in their hospitals is an impediment to error reporting, but that so many people who work in the patient safety arena are not surprised at the high number of people responding that way.
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To help frail Medicare Advantage members with multiple medical problems live independently at home, Independent Health Association in Buffalo, NY, works with Family Choice, a care management provider, to arrange home visits. During visits, they educate members about their healthcare conditions and treatment options, discuss medication, and arrange for needed services.
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At the Open Door Medical Center, a community health center in Ossining, NY, embedded case managers work with patients infected with HIV, helping them navigate the healthcare system and get the medical care and other assistance they need to keep their condition under control.
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All manner of electronic devices are common in any healthcare setting, and individuals increasingly are likely to use their own smart phones, tablets, and other personal electronics while at work. The proliferation of electronics is leading some patient safety experts to worry that patient safety might be threatened by "distracted doctoring."
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Previously, some scheduled surgery patients at Spectrum Health in Grand Rapids, MI, failed to return phone calls because they had just spoken to someone.
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[Editor's note: This is the first part of a two-part series on issues surrounding social media and ambulatory surgery. In this issue, we give you some horror stories and tell you how to avoid them. We tell you how to be proactive about your online presence, as well as how to develop a social media policy. Next month, we discuss legal issues and employee training.]
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While it is difficult to surprise me anymore, I discovered that in 2011 we opened more not-for-profit, freestanding, off-site hospital surgery centers then we did actual for-profit surgery centers. In looking at our current workload and "pipeline" projects, it looks like the trend is going to extend into 2012.