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Risk managers are obligated to take the proper steps to detect fraudulent activity and to avoid becoming a naive conspirator, says Steve Lee, an investigator with Steve Lee & Associates, a forensic accounting and litigation consulting firm in Los Angeles. He has consulted on a number of high-profile fraud cases and says risk managers can reduce their vulnerability to billing scams with a few simple precautions.
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The outbreak of a novel H1N1 virus in the spring was a colossal pandemic preparedness drill for a future virus or for a stronger resurgence of the strain this fall.
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Interesting things going on out there, aren't they? Town meeting riots, "death panels," trillion-dollar budgets, "evil businesses." As a clinician, a business owner, and a health care consumer (I broke my foot skydiving a few weeks ago), I've got to tell you: I am OK with the system as it is . . . almost.
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A combination of face-to-face and telephonic case management has resulted in high patient satisfaction ratings and a significant decrease in health care utilization for patients with complex medical needs.
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When a dedicated nurse and a quality improvement consultant come together, beautiful things can happen. It starts with an idea, a problem that begs for a solution, and then the work on finding the answers begins.
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Preventing patient falls is a constant struggle for hospitals. And as Medicare has cut reimbursement for falls as a "never event" and patients are getting increasingly older and sicker, it will continue to be a challenge.
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Inpatient surgery is on the fifth floor. L&D is on the third floor. The GI center is near the ED in the first floor. The outpatient surgery center is on two. The lithotripsy is in a trailer in the parking lot.
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The clear conclusion of a recently published study is preoperative cleansing of the patient's skin with chlorhexidine-alcohol is hands-down better to cleansing with povidone-iodine for preventing surgical-site infection after clean-contaminated surgery.1 Now it gets interesting.
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When Mendocino Coast Hospital in Fort Bragg, CA, recently underwent its accreditation survey by The Joint Commission, the biggest surprise was the scrutiny on and large amount of time spent in the operating room in the surgery area vs. the nurses' floor, says Susan Bivins, RN, the director of quality and risk management.
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Rhode Island Hospital, the teaching hospital for Brown University's Alpert Medical School in Providence, is facing unprecedented sanctions from the state health department after its fifth wrong-site surgery since 2007.