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The newly launched Health Care Notification Network (HCNN) has delivered the first online drug alerts to U.S. physicians.
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News: A man was admitted to the hospital complaining of anxiety and being under tremendous pressure at work. The man was seen by an internist and a neurologist, and antidepressant and anti-anxiety medications were administered. After a few days, the man's condition improved, and the results of a brain MRI came back normal. The next morning, the man asked his nurse for a razor so that he could shave. Three hours later, he was found dead, locked in the bathroom, having committed suicide with the razor.
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With today's shrinking health care dollars and pressure from payers to move patients through the continuum faster than ever, hospitals need to focus on improving patient flow. That's where case managers come in.
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It will take well-organized data to show your hospital administration how case managers can affect patient flow and to justify additional staff to focus on the effort, says Toni Cesta, RN, PhD, FAAN, vice president, patient flow optimization for the North Shore-Long Island Jewish Health System and health care consultant and partner in Case Management Concepts LLC.
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When patients are admitted to Alamance Regional Medical Center in Burlington, NC, care managers are responsible for assigning the DRG and length of stay and establishing medical necessity and the correct patient status.
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Payer denials for inappropriate observation patient status dropped by 50% the first year after Good Samaritan Hospital in Dayton, OH, instituted a case management protocol that delegates responsibility for determining patient status to case managers.
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Before developing a protocol that delegates authority for determining patient status to case managers, a multidisciplinary team at Good Samaritan Hospital in Dayton, OH, spent several months researching the process, seeking advice from the Florida Quality Improvement Organization (QIO) and hospitals in Florida that had piloted a case management admission status protocol.
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The emergency department at Middle Tennessee Medical Center (MTMC) in Murfreesboro certainly qualifies as busy: It sees nearly 63,000 patients a year and averages more than 170 patients a day. Yet the average time it takes a patient to get to triage from entry into the ED is 14-17 minutes, and its door-to-doc time averages 35-40 minutes.
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In announcing its final rule for the Hospital Outpatient Prospective Payment System (OPPS) for calendar year 2009, the Centers for Medicare & Medicaid Services (CMS) reiterated its intention to strengthen the tie between quality of care furnished to people in hospital outpatient departments and the payments hospitals receive for those services.
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Discharge planning for orthopedic surgery patients at one major hospital begins well in advance of patients being admitted for surgery.
