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Faced with denials for short stays and pressure to get patients out of the emergency department, Massachusetts General Hospital established an emergency department observation unit for patients whose stays are likely to be 24 hours or less.
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Make sure record is complete
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Hospitals stand to lose more reimbursement.
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In the Inpatient Prospective Payment System final rule for 2014, the Centers for Medicare & Medicaid Services established a benchmark of two midnights for an inpatient admission and issued robust requirements for documentation.
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Scottsdale Health System has seen a decrease in readmissions and emergency department visits among the elderly since the three-hospital system brought together all the community organizations and agencies to collaborate on improving transitions.
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Chart review remains of utmost importance
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Balancing the therapeutic needs of very sick patients with the demands of rigorous scientific research is a major ethical challenge in stem cell research, according to Mary Devereaux, PhD, director of the biomedical ethics seminars and assistant director of the Research Ethics Program at the University of California, San Diego (UCSD).
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The longstanding ethical framework for protecting human volunteers in medical research needs to be replaced because it is outdated and can impede efforts to improve health care quality, according to a Hastings Center Report special report, Ethical Oversight of Learning Health Care Systems.1
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Can functional neuroimaging, which is currently used largely in the research setting, be used as a clinically actionable tool for disorders of consciousness? This is an important and a loaded topic, says Judy Illes, PhD, FRSC, FCAHS, Canada Research Chair in Neuroethics and professor of neurology at the University of British Columbia in Vancouver, Canada.
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Patients in a minimally conscious state (MCS) demonstrate behaviors suggestive of consciousness episodically and intermittently, and because these behavioral signs are not reproducible, diagnostic errors can be quite high, says Joseph J. Fins, MD, MACP, the E. William Davis, Jr., MD, Professor of Medical Ethics and chief of the Division of Medical Ethics at Weill Cornell Medical College.