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When doctors, nurses, and other hospital operating room staff follow a written safety checklist to respond when a patient experiences cardiac arrest, severe allergic reaction, bleeding followed by an irregular heartbeat, or other crisis during surgery, they are nearly 75% less likely to miss a critical clinical step, according to a new study funded by the Agency for Healthcare Research and Quality (AHRQ).
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A proactive approach to the Recovery Auditor (RA) process has paid off for Alamance Regional Medical Center in Burlington, NC. Out of more than 800 denials from the auditor, the hospital has appealed up to the administrative law judge level, if necessary. So far, the hospital has won a high percentage of the appeals. Many are still pending because of a backlog.
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Gundersen Healths integrated care coordination program, in which a team of RN care coordinators and social workers follows the 1% to 2% most complex patients through the continuum, has resulted in a 46% decrease in average length of stay and a 64% decrease in unplanned hospital admissions or emergency department visits.
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As the Centers for Medicare & Medicaid Services (CMS) Value-Based Purchasing program moves toward basing reimbursement on quality, case managers can take the lead in making sure their hospitals score well and dont lose reimbursement.
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Patients who participate in Hospital Sisters Health System Medical Groups Nurse Navigator Program have shown significantly fewer emergency department visits and hospital visits as well as better control of their chronic conditions than patients who are not being followed by a nurse navigator.
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Regardless of the healthcare setting in which they work, case managers are likely to encounter challenging patients and family members those who are irate, provocative, depressed, or just plain ornery.
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Patient flow and boarding have been recognized for some time as problems that hospitals need to address. But whatever is being done isnt enough, and The Joint Commission (TJC) released a report in December outlining new standards in the Leadership section, some of which came into effect on January 1, and some of which will take effect in another year.
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To eliminate gaps in care after their members have been hospitalized, Cigna Medical Group has assigned RN care coordinators to local hospitals to act as a bridge between the primary care practice and the hospital and has a dedicated team of physicians, pharmacists, and nurses who see the majority of patients for their first follow-up visit.
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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.