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The nations insurance coverage crisis is even worse than many policy analysts have feared, with nearly 38% of Americans younger than age 65 going without insurance at some point over a four-year period from 1996-1999, according to a study sponsored by the Commonwealth Fund, a private, social research foundation based in New York City.
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Hospital case managers routinely face what I call the Bermuda Triangle of case management ethics. The top of the triangle is the clinical concern, encompassing the medical and treatment needs of the patient. On the right are the financial concerns, and on the left are the legal and ethical issues. In the middle of this triangle is the patient.
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As hospital discharge planners and case managers struggle to place patients with complex care needs in skilled nursing facility (SNF) beds amidst the challenges of the prospective payment system (PPS), many are keeping their heads above water with a mix of timely planning, community collaboration, and creative thinking.
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Health care organizations have been improving processes for years. Recently, however, the Joint Commission on Accreditation of Healthcare Organizations mandated that organizations use a proactive risk assessment technique failure mode and effect analysis (FMEA) to improve the safety of patient care activities.
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The Joint Commission on Accreditation of Healthcare Organizations has issued new infection control standards for 2005, emphasizing at a conference in Chicago that hospital executives not quality managers or infection control practitioners are going to have to take ultimate responsibility for enacting them.
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As hospital discharge planners and case managers struggle to place patients with complex care needs in skilled nursing facility (SNF) beds amidst the challenges of the prospective payment system (PPS), many are keeping their heads above water with a mix of timely planning, community collaboration, and creative thinking.
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Discharge planners at some facilities apparently are either unaware of -or are ignoring - a federal requirement that hospitals offer patients a choice of home care providers and that they tell patients when there is a financial interest between the hospital and an agency to which the patient is being referred.
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Its a frequent tactic of physicians: claiming that quality data are imperfect, invalid, or otherwise misleading. When physicians are not acting on proven data, the quality manager has to stand up to the physicians and protect the integrity of the data, says Frederick P. Meyerhoefer, MD, principal of the Canton, OH-based Meyerhoefer Organization, a consulting firm that specializes in compliance with Joint Commission on Accreditation of Healthcare Organizations standards.
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Some of the key aspects of the Joint Commission on Accreditation of Healthcare Organizations 2005 infection control standards are summarized here:
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Perhaps the hardest thing to get used to about the Joint Commission on Accreditation of Healthcare Organizations new survey process is the lack of any set agenda, says Helena Feather, vice president of compliance and health information at Trident Health System in Charleston, SC.
