Discharge Planning
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Case Management for Patients Nearing the End of Life
As the median age of the U.S. population increases, conversations around end-of-life care will need to be more robust. Hospital case managers often are among the only providers who might broach this topic with their patients. They need to be equipped for those conversations, even when the patient does not know what to think. Sometimes, the patients have not put much thought into their own values or priorities, and need someone to serve as a guide.
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Population Health Initiatives Could Include Focus on Spiritual Care
Spiritual care can be separated from the chaplain experience and focus on patients across the continuum, the author of a new paper suggests. Integrating spiritual care into outpatient, managed care, and population health can enhance patient care and improve the effectiveness of interdisciplinary teams.
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More Work Needed to Fight Healthcare Disparities
It takes a village to improve population health and whole person care. The village includes the public health system, which can be led by case management or a care coordination team. Populations that experience health inequities can benefit from the whole-person approach, particularly when hospitals form public health partnerships and use telehealth at discharge.
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High-Risk Patients Benefit From Direct Social Needs Assistance
A case management team can help high-risk patients access social assistance. But to be most effective, they need to help clients access psychosocial support and direct assistance for social needs. A health system’s program reduced inpatient hospitalizations by 11% in a randomized study.
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How to Fight Denials
Case managers do not have to settle for denials. In fact, they can use their skills to overturn denials. There are certain tactics that can help in this process, and some case management professionals even specialize in this.
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Solving Transportation Problems Improves Hospital’s Efficiency
Health systems that work to improve social determinants of health, including transportation, may find their actions improve patient care and follow-up, discharge, and throughput efficiency. For example, UCSF Health found case managers could more easily plan discharges and turn over beds once they solved the issue of finding rides home for clients without family or social support.
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Offering Transportation Services Is a No-Brainer for Some Health Systems
Case managers are logistical artists when it comes to helping patients handle care needs during hospitalization and transitions after discharge. But things can get out of control when patients leave the hospital, and transportation is a top obstacle to patients receiving necessary care in the community.
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Long COVID May Linger in Patients for Months or Years
The COVID-19 pandemic may be waning, but its effects continue as many patients experience long-term symptoms, including fatigue, brain fog, and other problems. Healthcare providers across the continuum may see these patients for months — and possibly for years.
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Out of Options: When Parents Abandon Pediatric Psychiatric Patients at Hospital
Parents often are faced with an impossible choice. They must decide whether to bring home a child who poses a threat to self and others, or risk a child abandonment charge. The criteria for acute psychiatric hospitalization are so high that children might be discharged only to be rehospitalized within weeks or days — and retraumatized in the process.
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Trauma Patients at Risk for Developing Opioid Use Disorder
Better identification and referral of patients with opioid use disorder could enhance the quality and continuity of care these patients receive, while also reducing reliance on EDs and the crowding that ensues.