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Every healthcare professional needs to develop a basic set of skills to help them cope with difficult patients so they can get through the encounter and not come out emotionally bruised, says John Banja, PhD, professor of rehabilitation medicine, medical ethicist at Emory Universitys Center for Ethics and director of the Section on Ethics in Research at Emorys Atlanta Clinical and Translational Science Institute.
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While new requirements are not always welcomed in the ED, to be sure, managers and front-line providers do have reason to feel optimistic about new standards, unveiled by The Joint Commission (TJC), regarding how hospitals manage patient flow.
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The emergency medicine community has pushed hard against complaints that too many patients with non-urgent needs are being seen in the ED, but there is little doubt that so-called super-utilizers patients who come to the ED regularly for one reason or another are not receiving the kind of care they need in the most appropriate setting.
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In the last two issues of Case Management Insider, we discussed issues associated with identifying and monitoring patient flow. This month we continue our discussion with a focus on the elements of patient flow associated with the inpatient setting. These issues relate directly to the provision of care as well as the progression of care for patients as they move through the acute-care continuum.
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When Patewood Memorial Hospital in Greenville, SC, opened six years ago, the hospital administration recognized an opportunity to provide care that was centered around the patients and family members experiences, or patient-centered care, says Beverly Haines, MNEd, BRN, NE-BC, president of the 72-bed surgical hospital, which is part of the Greenville Health System.
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Its no longer enough for case managers to create a discharge plan and forget about the patient as soon as he or she is out the door, advises Jackie Birmingham, RN, BSN, MS, CMAC, vice president emerita of clinical leadership for Curaspan Health Group, a Newton, MA-based transition management software company.
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When the Centers for Medicare & Medicaid Services (CMS) changed the way in which it would reimburse hospitals based on the number of Medicare 30-day readmissions they had, hospitals began a long journey of discovery.
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By analyzing heart failure readmissions and collaborating with post-acute providers and community organizations, Essentia Health-St. Josephs Medical Center in Brainerd, MN, cut its readmission rate from 18% to a low of 6%.
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Using a Centers for Medicare & Medicaid Services Innovation grant, Beth Israel Deaconess Medical Center in Boston launched a program to prevent readmissions.
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Nurses are at high risk of stress caused by work-family conflict (WFC) partly because of the physical and emotional demands of their long shifts. One solution could be to permit some worker self-scheduling, an expert says.
