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Checklists and clear protocols for clinical care have been highly successful in infection prevention and other fields.
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Ask a doctor if she thinks her hospital does a good job at care coordination or an administrator or board member and shed probably say yes. She might admit to room for improvement, but in all likelihood, she would think she and her peers do a good job taking care of patients in and out of the acute care setting. But the reality is different, says quality guru and Harvard professor Lucian Leape, MD, chairman of an eponymous institute at the National Patient Safety Foundation.
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The fast pace of a busy ED can make it difficult to focus in on processes that could be improved, but leadership and commitment can move the needle in the right direction as long as emergency personnel understand why change is important. That, at least, is what Erin Muck, RN, the ED manager and trauma coordinator at Avera Marshall Regional Medical Center, a 25-bed hospital in Marshall, MN, has discovered. The ED treats about 7,200 patients annually, and 100 patients per month are admitted to the hospital from the ED
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By coordinating care between behavioral health and medical health providers, Connected Care, part of UPMC Insurance Division, has reduced hospital admissions and emergency department visits for members of UPMC for You, a Medicaid managed care plan as well as Community Care Behavioral Health which manages services for recipients of Pennsylvanias medical assistance program. Case managers at both organizations share a database that shows physical health and mental health interventions for patients in the program. When patients receive services from a mental health or physical health provider or are hospitalized, the care managers make sure all of the patients providers are aware of what has happened. A multidisciplinary team from both organizations develops a plan of care for individuals and assigns a lead case manager who coordinates care with the patients providers.
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Researchers and healthcare organizations alike recognize the connection between physical conditions and behavioral health conditions and are working to coordinate care between the providers.Many people with chronic diseases also suffer from depression and other behavioral health issues.People with mental health problems die earlier than the general population because they smoke, are overweight, and have chronic illnesses. Behavioral and physical healthcare providers often operate in silos and lack coordination, which can result in a negative impact on individuals.
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The American College of Surgeons (ACS) and Commission on Cancer (CoC) have released separate lists of specific tests or procedures that are commonly ordered but not always necessary in surgery and surgical oncology.
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Nobody wants to run afoul of the Stark law or other fraud prevention regulations, but it happens.
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The head of The Joint Commission is urging hospitals to make substantial changes to achieve the ultimate goal of zero patient harm by adapting lessons from high-risk industries.
