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Since case management's entry into the acute care setting in the mid-1980s, most of the significant changes in health care delivery have been associated with changes in health care's reimbursement structure.
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Faced with an influx of patients following Hurricane Katrina, North Oaks Health System in Hammond, LA, placed case managers in the emergency department, an initiative that ultimately led to 24-7 coverage by emergency department case managers.
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A new regulation from the Centers for Medicare & Medicaid Services (CMS) will have a far-reaching impact on Medicare patients and their providers, including hospital-based case managers, says Jackie Birmingham, RN, BSN, MS, vice president of regulatory monitoring and clinical leadership at Curaspan Health Group.
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Beginning with discharges on Oct. 1, 2012, your hospital's reimbursement could be affected by its performance on quality measures as the Centers for Medicare & Medicaid Services (CMS) implements the value-based purchasing program mandated by the Patient Protection and Affordable Care Act.
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"The industry is moving to more on-site care. Nurse practitioners and on-site clinics are increasing,"
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The 12-hour shift, mainstay of the nursing schedule, may be unhealthy for nurses and their patients.
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When Washington County Health System (now known as Meritus Health) in Hagerstown, MD, first sought to measure the health status of its employees, the results were startling. Thirty-eight employees had undiagnosed diabetes or high blood pressure. More than 500 had glucose levels that placed them at high risk for developing diabetes. Other employees had high blood pressure, high cholesterol, or other risk factors.
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At a secondary lead smelter in Pennsylvania, monetary incentives have been effective in improving processes, such as keeping blood lead levels down. "It does work, especially when it is a separate line item on their pay stub and the wife can see that!" says occupational health nurse Laurie Heagy, RN, COHN-S.
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If employees don't trust you, they probably won't listen to your advice, agree to take a health risk assessment, or participate in your wellness programs.