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A patient arrived from an assisted living facility with a documented allergy on the chart. Despite this safeguard, the patient still received an incorrect medication prior to the procedure. Fortunately, in this case, there was no lasting harm to the patient.
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Disclosing a medical error is never easy, but it can become especially complicated when you need to tell the patient that a previous provider was in the wrong. This delicate situation often requires communication with the other provider before you tell the patient anything.
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Educators often talk about "teachable moments," those times when the patient is ready to learn. This moment might be in a waiting area, exam room, or a hospital bed. To take advantage of these times, staff members in the Section of Patient Education at Mayo Clinic in Rochester, MN, look for new ways to deliver patient education.
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The ethical decision-making process is similar to the case management process and the nursing process. The steps include:
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Now that the Centers for Medicare and Medicaid Services (CMS) has launched a program that adjusts Medicaid payments for provider-preventable conditions, including healthcare-acquired conditions, it's essential for case managers to work with physicians to make sure all conditions that are present on admission are clearly documented on a patient's chart.
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One solution to perennial problems such as ethics issues might be the formation of an organizational ethics committee. Different from a clinical ethics committee, an organizational ethics committee deals with organizational dilemmas that should be solved in a formalized manner.
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I will never forget my biggest ethical dilemma. It happened when I was a director of case management at a large medical center in New York City. It was the day after Thanksgiving.
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When case managers think about ethical dilemmas, they are thinking about much more than when to discontinue a ventilator, or to stop treatment, or any of the myriad of clinical ethical decisions that must be made every day in hospitals throughout the United States.
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More often, registrars are finding themselves in the difficult position of educating patients about their insurance coverage, according to Steph Collins, manager of patient access at Fairview Northland Health Services in Princeton, MN.
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The Medical Center of Central Georgia in Macon was an early adopter of registration kiosks, says Jane Gray, CPA, FACHE, FHFMA, assistant vice president for the revenue cycle.