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Lean management techniques helped Lahey Clinic Medical Center, North Shore, in the city of Peabody, MA, boost patient satisfaction and reduce emergency department (ED) waiting times.
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As if the False Claims Act (FCA) wasn't already enough of a headache for risk managers, recent changes to the law could bring even more reason to worry. Risk managers should be aware of how the Fraud Enforcement and Recovery Act of 2009 (FERA) will affect them, says Richard Glovsky, JD, a partner with the Boston-based law firm Prince Lobel.
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Risk managers are obligated to take the proper steps to detect fraudulent activity and to avoid becoming a naive conspirator, says Steve Lee, an investigator with Steve Lee & Associates, a forensic accounting and litigation consulting firm in Los Angeles. He has consulted on a number of high-profile fraud cases and says risk managers can reduce their vulnerability to billing scams with a few simple precautions.
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Bon Secours St. Francis Health System received nearly $2 million in denials and successfully appealed the vast majority of them during the few months the Greenville, SC, hospital was part of the Recovery Audit Contractor (RAC) demonstration project, says James T. Jones, PhD, RN, administrative director, case management and patient documentation for the Bon Secours St. Francis Health System.
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A combination of face-to-face and telephonic case management has resulted in high patient satisfaction ratings and a significant decrease in health care utilization for patients with complex medical needs.
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When a dedicated nurse and a quality improvement consultant come together, beautiful things can happen. It starts with an idea, a problem that begs for a solution, and then the work on finding the answers begins.
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Preventing patient falls is a constant struggle for hospitals. And as Medicare has cut reimbursement for falls as a "never event" and patients are getting increasingly older and sicker, it will continue to be a challenge.
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Several months ago, the two EDs of Sacred Heart Medical Center in Eugene, OR, began posting their waiting times on their home page (www.peacehealth.org/shmc).
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When Henrico Doctor's Hospital in Richmond, VA, launched a hospitalwide initiative to improve patient throughput, the team was able to shave 2.5 hours off the average discharge time and decrease the average length of stay on the medical unit from almost 10 days to five days in the first six months of the project.
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North Shore-Long Island Jewish Health System based in Great Neck, NY, was awarded with the National Quality Forum's 2010 National Quality Healthcare Award.