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UCLA Health System in Los Angeles reduced length of stay and improved patient throughput by using a "strategic triad" of initiatives that includes interdisciplinary rounds, clinical high-risk meetings, and use of escalation to overcome barriers to discharge.
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If patients are admitted to the hospital when outpatient services were appropriate, the level of care can be changed, but there's a lot of paperwork involved to correct the error.
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Helping your hospital optimize reimbursement and avoid losing money in today's healthcare audit environment starts with ensuring that the patient is in the right level of care from the beginning and this means making sure that observation services are ordered only when they are appropriate.
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By revamping the discharge process and working with post-acute providers, UConn Health Center/John Dempsey Hospital, Farmington, CT, reduced 30-day heart failure readmissions from 25.1% in August 2010 to 17% in March 2012.
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Operating a small hospital doesn' t mean you can' t think big. Ellenville Regional Hospital (ERH), a 25-bed rural hospital in Wawarsing, NY, is enjoying success with a medication reconciliation and patient safety project that would be the envy of any large teaching institution by reducing medication-related events to a very low 0.1 occurrences per 1,000 doses dispensed.
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The Agency for Healthcare Research and Quality (AHRQ) has created a website with a wealth of tools to help hospitals set up the Comprehensive Unit-based Safety Program (CUSP). (www.ahrq.gov/cusptoolkit) Frontline users that have implemented CUSP say they not only reduced infections, but dramatically transformed their overall patient safety culture.
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Presbyterian Healthcare Services' Hospital at Home program, which provides acute care services in the homes of patients who might otherwise be hospitalized, has improved patient satisfaction and cut the cost of hospital care by about 30% for the Albuquerque, NM-based integrated healthcare delivery system.
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Case managers have the opportunity to provide valuable assistance to their patients who are frequently readmitted to the hospital with advanced chronic illnesses or who are approaching end of life, says Jennie Roberts, RN, CCM, MBA, chief nursing officer for Evercare Hospice and Palliative Care, based in Minneapolis, which provides hospice and palliative care services throughout the country.
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In today's healthcare environment, as payers tighten reimbursement and auditors from Centers for Medicare & Medicaid Services and commercial payers increase their scrutiny of hospital records, hospitals need to ensure that all patients are admitted in the right level of care and that they move through the continuum as quickly and safely as possible.
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One of the problems associated with the boarding of admitted patients in the ED is that the practice inevitably leads to increased diversion when the ED's capacity to care for new patients is diminished.
