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(Editor's note: This is the second article in a two-part series. In the first article, we discussed the decision of the leaders of the EDs at Sacred Heart Medical Center in Eugene, OR, to begin posting their waiting times on the Internet. In this installment, we examine the process they used to make sure the system was running smoothly before they officially started.)
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A few hours after a chest pain patient was worked up and discharged with a noncardiac diagnosis in a Virginia ED, he was brought back dead on arrival.
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Recognizing and re-emphasizing the fact that children are a distinct population of patients in the ED, the American Academy of Pediatrics, the American College of Emergency Physicians (ACEP), and the Emergency Nurses Association (ENA) have released a joint policy statement that includes guidelines for the care of children in EDs. The statement was published online in the journal Pediatrics.
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If the discharge planning community's ideal is to begin the discharge process at the door, when patients are admitted to the hospital, then community provider input is necessary for a smooth care transition.
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If your hospital has been focusing solely on improving Medicare records in preparation for the permanent Recovery Audit Contractor (RAC) program, you may find yourself in a bind as other payers roll out their own audit programs.
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By the end of the year, it's likely that every type of medical record in your hospital will be scrutinized by one auditor or another, predicts Brian Flood, managing director for KPMG LLP, the U.S. audit, tax, and advisory firm.
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The hospital quality manager should play an important role in the implementation of an Integrated Nurse Leadership Program (INLP), says Julie Kliger, MPA, BSN, RN, INLP creator and program director at the Center for the Health Professions, University of California, San Francisco; principal and founder of The Altos Group; and lead author of an article in the Joint Commission Journal on Quality and Patient Safety detailing the successful implementation on INLP in seven Bay Area hospitals that led to significant improvements in medication administration.
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It appears that the federal government's vision of a nationwide health IT network is starting to become a reality, with the launch of a pilot program by the Department of Veterans Affairs and Kaiser Permanente soon to be joined by the Department of Defense that will allow the exchange of electronic health record information between VA and Kaiser providers (and soon the DoD as well) for veterans who receive care from both entities and agree to participate.
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As hospital systems add new technology to improve and change pharmacy department workflow, medication management also evolves and changes. This requires pharmacy leaders to anticipate new safety concerns and develop new practice models.
