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As part of the efforts to ensure that admissions are appropriate, Covenant Health System, with headquarters in Knoxville, TN, is conducting a pilot project to test the effectiveness of having utilization managers review patients admitted to the hospital, and work with the admitting physician to decide whether the patient should be admitted or receive observation services as an outpatient.
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In the last two issues of Case Management Insider, we reviewed the roles and functions most often associated with the work of case managers in the acute care setting.
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By identifying community resources for homeless and near-homeless patients, Montefiore Medical Center in the Bronx, NY, is cutting down preventable admissions.
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As part of its efforts to cut improper payments, the Centers for Medicare and Medicaid Services (CMS) has launched a three-year Recovery Audit program prepayment review demonstration project in 11 states.
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They knew it was coming: The National Institute of Standards and Technology's (NIST) proposed budget didn't include any government funding for the Baldrige National Quality Awards. But it still comes as a shock, particularly to those who have participated in the program and know firsthand the benefits that participants reap.
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A report from the Health and Human Services' Office of Inspector General released at the end of October concluded that the Centers for Medicare & Medicaid Services isn't addressing some of the serious events that happen in hospitals or letting The Joint Commission know about them in a timely manner.
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Many times it takes significant changes in processes and/or policies to effect improvements in quality performance.
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In the first weeks after The Joint Commission and SGS Group announced they would be offering joint accreditation and ISO certification to interested hospitals, SGS reported a fourfold increase in calls from hospitals curious about what ISO could do for them.
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A RAND study released in December looked at the use of performance measures and the barriers to using them.
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In the 25 years since the Picker Institute was founded to focus on patient-centered care, the organization has specialized in talking about the positive part of healthcare the things that should always be done that benefit the patient and family rather than about those never events that make headlines.
