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At Loma Linda (CA) University Medical Center, ED nurses have decreased door-to-EKG time to 11 minutes from almost an hour a year ago, reports Teri D. Reynolds, RN, BSN, clinical educator in the department of emergency services.
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As the result of an initiative in which the entire hospital staff collaborate to improve length of stay, Spartanburg (SC) Regional Healthcare System's average severity-adjusted length of stay has dropped from an average of 5.40 days in 2007 to an average of 5.18 days so far in 2008.
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As the Centers for Medicare & Medicaid Services (CMS) moves to strengthen the tie between quality of care and hospital reimbursement, hospitals should take a systematic and universal approach to identifying patients at risk and preventing hospital-acquired conditions for all patients and not just those covered by Medicare, says Leslie Schultz, RN, NEA-BC, PhD, CPHQ, director, knowledge transfer for Premier Inc.
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When a patient discharged on a Friday is back in the hospital the following Monday, there can be many reasons.
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Case managers should be involved in their hospitals' efforts to ensure compliance with the Centers for Medicare & Medicaid Services (CMS) regulations that require documentation of conditions that are present on admission and deny payment for certain conditions acquired during the hospital stay, experts say.
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The Centers for Medicare & Medicaid Services (CMS) continues to move at a rapid pace toward value-based purchasing, proposing expansion in hospital quality reporting requirements and increasing the number of hospital-acquired conditions for which Medicare won't reimburse.
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Once a patient with violence-related traumatic injuries is stable and about to be discharged, you have to consider something equally important: Will he or she be safe after leaving your ED?
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An outpatient surgery patient shows up with-out an escort to drive him home. Despite the nurse's insistence, the patient indicates he doesn't have anyone who can escort him. There is no cab or public transportation available. Reluctantly, the case continues, and the patient drives himself home.
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Faced with an increase in emergency department visits and a rising inpatient census, the chief executive officers at Massachusetts General Hospital in Boston made ED overcrowding a major quality and safety initiative of the hospital starting in 2006 and took a systemwide approach to addressing the problem.
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In its proposed rule for the Outpatient Prospective Payment System, issued July 3, 2008, the Centers for Medicare & Medicaid Services (CMS) continued its efforts to tie reimbursement to quality of services, adding four new outpatient quality measures that hospitals must report on and asking for public comments on an additional 18 measures being considered for future years.