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In the December 2011 issue of Case Management Insider we discussed the roles most commonly used by case managers in today's acute care setting. These included the following:
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After his cheek was fractured when a patient smashed a fist into his jaw in the emergency department, Jeaux Rinehart, RN, BSN, PHN, figured he'd had enough. He worked for 32 years as an emergency room nurse and loved it, but finally he could no longer tolerate patients hitting, yelling, cursing, or spitting at him.
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Occupational health should consider an employee's tobacco dependence as a "chronic relapsing condition," according to the Office of the Surgeon General's Treating Tobacco Use and Dependence clinical practice guideline 2008 update.
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While medication adherence is a critical element in reducing the impact of illness, employers should view it as just one of many components that are needed in strategic employee health management initiatives.
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If you're not paying as much attention to documentation and medical necessity for Medicaid patients as you do for those covered by Medicare, your hospital is likely to suffer when the Medicaid Recovery Audit Contractor (RAC) program starts on Jan. 1, 2012.
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When it's typical for patients to wait four hours or more to see an emergency physician, and your leave-without-being-seen (LWBS) rate is pushing 10%, you know it's time to rethink the whole process.
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In response to comments from healthcare professionals, the Centers for Medicare and Medicaid Services (CMS) made significant changes to the final rule for the creation of accountable care organizations (ACOs), which encourage providers to better coordinate care across all settings.
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After Charleston (WV) Area Medical Center began a readmission reduction program, readmission rates for a group of targeted heart failure patients was reduced by 50%.
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Key components of the initiatives include forging an alliance with post-acute providers, transition coaching for at-risk patients during the hospital stay and after discharge, and teaching patients to use their personal health record to track their care and list questions for providers, according to Tammy Cole-Poklewski, RN, MS, director of quality, patient safety, and care management at the 142-bed facility.
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(Editor's note: This is a multi-part series where we will explore the most common roles, functions, models, and caseloads in the hospital case management field.)