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If you have the emergency department volume and the staffing, covering the emergency department 24 hours a day, seven days a week is optimal, according to Joanna Malcolm, RN, CCM, BSN, consulting manager, clinical advisory services for Pershing, Yoakley & Associates in Atlanta.
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The case management department at Lee Memorial Health System in Fort Myers, FL, has been able to demonstrate a savings of $4.5 million as a result of having case managers in the emergency department.
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Arm yourself with data before approaching the administration about establishing an emergency department case management department, increasing staff, or changing hours.
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As part of Memorial Health System's adoption of the Toyota Lean Processes, the case management department at Saddleback Memorial Hospital in Laguna Hills, CA, has standardized work flow for discharging patients and is piloting the process on one unit.
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The Medical Center of Central Georgia in Macon was an early adopter of registration kiosks, says Jane Gray, CPA, FACHE, FHFMA, assistant vice president for the revenue cycle.
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More often, registrars are finding themselves in the difficult position of educating patients about their insurance coverage, according to Steph Collins, manager of patient access at Fairview Northland Health Services in Princeton, MN.
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When case managers think about ethical dilemmas, they are thinking about much more than when to discontinue a ventilator, or to stop treatment, or any of the myriad of clinical ethical decisions that must be made every day in hospitals throughout the United States.
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I will never forget my biggest ethical dilemma. It happened when I was a director of case management at a large medical center in New York City. It was the day after Thanksgiving.
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One solution to perennial problems such as ethics issues might be the formation of an organizational ethics committee. Different from a clinical ethics committee, an organizational ethics committee deals with organizational dilemmas that should be solved in a formalized manner.
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Now that the Centers for Medicare and Medicaid Services (CMS) has launched a program that adjusts Medicaid payments for provider-preventable conditions, including healthcare-acquired conditions, it's essential for case managers to work with physicians to make sure all conditions that are present on admission are clearly documented on a patient's chart.
