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When Haywood Regional Medical Center in Clyde, NC, began tracking case management interventions, staff began by looking at variances in care and documenting them to see how they could improve patient care.
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A few years ago, the masters prepared social workers (MSWs) and RN case managers at Hoag Memorial Hospital Presbyterian in Orange County, CA, were having the usual disagreements over who should do what for which patient and who was carrying the heavier load.
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A process begun four years ago when the Medical University of South Carolina (MUSC) in Charleston took a hard look at pending discharges has led to a cutting-edge bed management program and a best practice designation from two national benchmarking organizations.
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With nursing units swamped in the afternoon with unscheduled admissions, nurses at the Medical University of South Carolina in Charleston were complaining about the arduous database they had to complete on admission of each patient, notes Maureen McDaniel, RN, manager, bed management, in the patient access services department.
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Access managers continue to debate the intricacies of the Emergency Medical Treatment and Labor Act (EMTALA), despite the publication of an EMTALA final rule on Sept. 9, 2003 by the Centers for Medicare & Medicaid Services (CMS). The rule became effective Nov. 10, 2003.
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When Teresa C. Fugate, RN, BBA, CPHQ, CCM, developed the case management program for a hospital in which she worked, she included a provision promising that what the case managers saved by preventing extra days and avoiding denials would equal their salaries plus benefits.
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Before Hoag Memorial Hospital Presbyterian in Orange County, CA, started its collaborative care initiatives for case management and social work, the two disciplines often were at odds with each other.
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Every day, we are confronted by problems that need solving. The problem might present itself simply as a minor inconvenience, or the problem may be a significant variance from ideal clinical practices. Whatever challenges your organization faces, effective problem-solving skills are needed to deal with the issues.
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Control charts, quality tools that can help tighten the focus on process variations, increasingly are gaining acceptance among some health care quality professionals. In fact, a number of Joint Commission on Accreditation of Healthcare Organizations requirements specifically mention the use of control charts.