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A jury awarded $25 million to a 41-year-old man who experienced a severe heart attack only a few months after being given ibuprofen to treat his heart condition.
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Recent media coverage showed a dramatic 911 call between an emergency dispatcher and a nurse at a retirement home who refused to perform cardiopulmonary resuscitation (CPR) on an elderly woman who was unresponsive.
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New provisions and clarifications in the Health Insurance Portability and Accountability Act (HIPAA) omnibus rule might have some hospitals scrambling to determine their compliance level, but it might not be a situation that requires outside help.
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The importance of encryption is emphasized with most of the recent major breaches added to the Department of Health and Human Services (HHS) list of breaches. Seven of the breaches involved laptops, while the other two involved paper records.
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Protecting the contents of a root cause analysis (RCA) requires much more than slapping a peer review label on the file and assuming that label means it is off limits to prying eyes. Peer review privilege might not protect your RCA at all, but there are other ways to limit the potential downside from someone reading about all your shortcomings.
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When Patewood Memorial Hospital in Greenville, SC, opened six years ago, the hospital administration recognized an opportunity to provide care that was centered around the patients and family members experiences, or patient-centered care, says Beverly Haines, MNEd, BRN, NE-BC, president of the 72-bed surgical hospital, which is part of the Greenville Health System.
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In the last two issues of Case Management Insider, we discussed issues associated with identifying and monitoring patient flow. This month we continue our discussion with a focus on the elements of patient flow associated with the inpatient setting. These issues relate directly to the provision of care as well as the progression of care for patients as they move through the acute-care continuum.
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As the Centers for Medicare & Medicaid Services (CMS) Value-Based Purchasing program moves toward basing reimbursement on quality, case managers can take the lead in making sure their hospitals score well and dont lose reimbursement.
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Gundersen Healths integrated care coordination program, in which a team of RN care coordinators and social workers follows the 1% to 2% most complex patients through the continuum, has resulted in a 46% decrease in average length of stay and a 64% decrease in unplanned hospital admissions or emergency department visits.
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A proactive approach to the Recovery Auditor (RA) process has paid off for Alamance Regional Medical Center in Burlington, NC. Out of more than 800 denials from the auditor, the hospital has appealed up to the administrative law judge level, if necessary. So far, the hospital has won a high percentage of the appeals. Many are still pending because of a backlog.
