{"title":"Collecting Data is a Key to Success — But You Have to Use it, Too.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 2","pages":"20-1"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36417708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Continue Communication After Patients Leave the Hospital.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36419292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Medicare readmission reduction program has been in place for five years but, despite decreasing readmissions, hospitals are still receiving penalties — $528 million in fiscal 2017 alone. The program has been criticized for basing penalties on a tiered structure so hospitals may be penalized despite cutting readmissions, and for not taking into account socioeconomic issues and other factors beyond hospitals' control that result in patients getting sicker. To help hospitals succeed, and to provide better care, case managers should work to prevent readmissions for all patients, including the Medicaid population, and adapt readmission prevention initiatives to meet the specific needs of patients in different demographic groups or with different conditions. Case managers should work closely with their counterparts at other levels of care to develop consistent educational tools and share information via the electronic medical record or nurse-to nurse calls to ensure smooth transitions and provide follow-up education and medication reconciliation for patients discharged to home. Case managers in the ED are essential to begin the discharge planning assessment while the family is still present and to prevent readmissions by lining up services in the community when appropriate.
{"title":"Readmissions Are Down, Penalties Are Up — What Do You Do Now?","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Medicare readmission reduction program has been in place for five years but, despite decreasing readmissions, hospitals are still receiving penalties — $528 million in fiscal 2017 alone.\u0000The program has been criticized for basing penalties on a tiered structure so hospitals may be penalized despite cutting readmissions, and for not taking into account socioeconomic issues and other factors beyond hospitals' control that result in patients getting sicker.\u0000To help hospitals succeed, and to provide better care, case managers should work to prevent readmissions for all patients, including the Medicaid population, and adapt readmission prevention initiatives to meet the specific needs of patients in different demographic groups or with different conditions.\u0000Case managers should work closely with their counterparts at other levels of care to develop consistent educational tools and share information via the electronic medical record or nurse-to nurse calls to ensure smooth transitions and provide follow-up education and medication reconciliation for patients discharged to home.\u0000Case managers in the ED are essential to begin the discharge planning assessment while the family is still present and to prevent readmissions by lining up services in the community when appropriate.</p>","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36419291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reduce Readmissions with Better Data Analysis.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"13-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36417706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Readmission Reduction Starts in the ED.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36419294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improve the Quality of Your Case Management Department through Staffing, Part 1.","authors":"Toni Cesta","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36419293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wake Forest Baptist Medical Center’s transitional stroke clinic, developed to provide standardized care for stroke patients discharged to home, resulted in a 48% lower risk of 30-day readmissions among patients who made just one visit to the clinic. The clinic is run by nurse practitioners who see patients within 14 days of discharge and assess them for medical, cognitive, and psychosocial needs, conduct medication reconciliation, and screen for caregiver burnout. Patients attend the clinic in addition to going to their regular follow-up visits with the neurology clinic, their primary care providers, and therapy sessions. The model also includes follow-up phone calls by an RN within two days of discharge to ensure patients have filled their prescriptions and know how to take their medication, if any equipment has arrived, and to continue the education started in the hospital.
维克森林浸信会医疗中心(Wake Forest Baptist Medical Center)的过渡性中风诊所旨在为出院回家的中风患者提供标准化护理,结果发现,只去一次诊所的患者在30天内再次入院的风险降低了48%。诊所由执业护士管理,他们在病人出院后的14天内对他们进行检查,评估他们的医疗、认知和社会心理需求,进行药物调解,并筛查护理人员的倦怠。患者除了去神经病学诊所,他们的初级保健提供者和治疗会议的定期随访外,还参加诊所。该模式还包括由注册护士在出院后两天内跟进电话,以确保患者已按处方服药,并知道如何服药,如果有任何设备已经到达,并继续在医院开始的教育。
{"title":"Transitional Stroke Clinic Lowers 30-Day Readmissions.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Wake Forest Baptist Medical Center’s transitional stroke clinic, developed to provide standardized care for stroke patients discharged to home, resulted in a 48% lower risk of 30-day readmissions among patients who made just one visit to the clinic.\u0000The clinic is run by nurse practitioners who see patients within 14 days of discharge and assess them for medical, cognitive, and psychosocial needs, conduct medication reconciliation, and screen for caregiver burnout.\u0000Patients attend the clinic in addition to going to their regular follow-up visits with the neurology clinic, their primary care providers, and therapy sessions.\u0000The model also includes follow-up phone calls by an RN within two days of discharge to ensure patients have filled their prescriptions and know how to take their medication, if any equipment has arrived, and to continue the education started in the hospital.</p>","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"11-2"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36417704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Get Ready: The Recovery Auditors Are Coming Your Way.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"12-3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36417707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cross-continuum Collaboration is Essential in Today’s World.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"25 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36419289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"It Takes Data to Improve Patient Flow.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79972,"journal":{"name":"Hospital case management : the monthly update on hospital-based care planning and critical paths","volume":"24 12","pages":"165-6"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36419286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}