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When the clinical nurse specialists and case managers at Akron, OH-based Summa Health analyzed the reasons patients were being readmitted within 31 days, they determined that mobility issues, self-care deficits, pain control, and failure of discharge planning were key factors.
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After Summa Health System began a series of initiatives to provide a seamless transition as patients move between levels of care, the rate of hospital readmissions within 31 days dropped from 26% to 24%.
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Sharon Spencer, RN, was working around the house on a Saturday evening when she got word that Columbus (IN) Regional Hospital, where she is employed as a case manager, was being evacuated because of a flash flood.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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"When I conduct an initial review of the chart, I read it from the beginning, like a story starting with the emergency department notes, through the history and physical and start building a story from a clinical standpoint.
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Regular audits and continuing education are the keys to a successful documentation assurance program, says Liz Youngblood, RN, MBA, vice president, patient care support services at Baylor Health Care System in Dallas.
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If your documentation assurance program focuses on reimbursement alone, you're not going far enough. With pay-for-performance initiatives on the rise and increasing mandates for public reporting of hospital data, it's critical that the medical record accurately reflect the severity of illness and the services provided to your patients.
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Medicaid now pays for 26% of total mental health expenditures, and rising costs of these services is a big concern for state Medicaid directors, according to a recent 50-state Medicaid budget survey from the Kaiser Family Foundation's Kaiser Commission on Medicaid and the Uninsured, Headed for a Crunch: An Update on Medicaid Spending, Coverage and Policy Heading into an Economic Downturn.
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According to a November 2008 report from Washington, DC-based Health Management Associates, targeted, highly customized interventions for people with chronic diseases can be an effective tool for reducing hospital readmissions.
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Even in good economic times, Medicaid directors have limited resources to do all that recipients, families, providers, legislators and taxpayers expect of them.