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Regular audits and continuing education are the keys to a successful documentation assurance program, says Liz Youngblood, RN, MBA, vice president, patient care support services at Baylor Health Care System in Dallas.
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"When I conduct an initial review of the chart, I read it from the beginning, like a story starting with the emergency department notes, through the history and physical and start building a story from a clinical standpoint.
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An emergency physician is managing an acute myocardial infarction, arranging for a patient transfer, sewing up a laceration, and putting in a chest tube, with 20 people still waiting to be seen in the waiting room.
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It's a situation case managers encounter with agonizing frequency: physicians who keep pumping medication into patients who are terminally ill or families who insist on continuing treatment when the clinical picture indicates that the patient's condition is terminal.
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If you want to effectively help patients and family members with end-of-life issues, you need to examine your own feelings about death and dying, says Catherine M. Mullahy, RN, BS, CRRN, CCM.
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Despite an increasing number of visits to the emergency department, Nyack (NY) Hospital has been able to meet its standard of 30-minute service 95% of the time and decreased its discharge length of stay in the ED by 35%.
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In today's health care environment, case managers are under more pressure than ever to discharge patients from acute care; but before you send patients home with home health care, home medical equipment, or hospice services, make sure that they are appropriate for those services, advises Elizabeth Hogue, Esq., a Washington-DC based attorney specializing in health care issues.
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If your hospital is like most, patients admitted through the emergency department are being held, possibly in hallways, for hours and even days.
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The largest health plans appear to be in the process of adopting guidelines from the Workgroup for Electronic Data Interchange (WEDI) for machine-readable insurance cards, according to Peter Barry, of Peter T. Barry Co., a Milwaukee-based consulting firm specializing in health care and information systems. Barry is chair of WEDI's initiative on health identification cards.
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After Concord (NH) Hospital's multidisciplinary cardiac care team began holding daily collaborative rounds with patients and family members on the cardiac patient care unit, length of stay decreased and patient satisfaction scores rose.
