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Author: Danielle Nay Richins
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 0
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Book Description
Preventable readmissions can occur due to a lack of patient education, preparation, and support and can be costly to hospitals and patients. Evidence indicates the follow-up phone calls and using transition coaches can reduce unnecessary readmissions and improve patient outcomes. The early identification of patient-specific needs and learning barriers can support quality patient care and reduce the likelihood of readmission. Additionally, including the caregiver throughout the discharge process is essential for preparing patients to self-manage diseases at home. This project aims to reduce readmission rates through optimal patient education, discharge planning, and support through the transition from hospital to home. This project will include educational resources for nurses stepping into the transition coach role, a readmission risk health needs assessment, and additional templates for identifying the required transitional care services. These resources will prepare nurses to support patients through discharge to decrease unnecessary readmissions and associated costs.
Author: Danielle Nay Richins
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 0
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Book Description
Preventable readmissions can occur due to a lack of patient education, preparation, and support and can be costly to hospitals and patients. Evidence indicates the follow-up phone calls and using transition coaches can reduce unnecessary readmissions and improve patient outcomes. The early identification of patient-specific needs and learning barriers can support quality patient care and reduce the likelihood of readmission. Additionally, including the caregiver throughout the discharge process is essential for preparing patients to self-manage diseases at home. This project aims to reduce readmission rates through optimal patient education, discharge planning, and support through the transition from hospital to home. This project will include educational resources for nurses stepping into the transition coach role, a readmission risk health needs assessment, and additional templates for identifying the required transitional care services. These resources will prepare nurses to support patients through discharge to decrease unnecessary readmissions and associated costs.
Author: Kerm Henriksen
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 526
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Book Description
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Author: Kaveh G. Shojania
Publisher:
ISBN: 9781587632594
Category : Disaster hospitals
Languages : en
Pages : 7
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Book Description
Author: Thomas L. Hafemeister
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
In the early years of the Twenty-First Century, it was widely speculated that massive, multi-purpose hospitals were becoming the 'dinosaurs' of health care, to be largely replaced by community-based clinics providing specialty services on an outpatient basis. Hospitals, however, have roared back to life, in part by reworking their business model. There has been a wave of consolidations and acquisitions (including acquisitions of community-based clinics), with deals valued at $7.9 billion in 2011, the most in a decade, and the number of deals increasing another 18% in 2012. The costs of hospital care are enormous, with 31.5% ($851 billion) of the total health expenditures in the United States in 2011 devoted to these services. Hospitals are placing growing emphasis on increasing revenue and decreasing costs; engaging in pervasive marketing campaigns encouraging patients to view hospitals as an all-purpose care provider; geographically targeting the expansion of their services to 'capture' well-insured patients, while placing greater pressure on patients to pay for the services delivered; increasing their size, wealth, and clout, with two-thirds of hospitals undertaking renovations or additional construction and smaller hospitals being squeezed out, and expanding their use of hospital-employed physicians, rather than relying on community-based physicians with hospital privileges, and exercising greater control over medical staff. Hospitals have become so pivotal in the U.S. healthcare system that the Patient Protection and Affordable Care Act of 2010 (PPACA) frequently targeted them as a vehicle to enhance patient safety and control escalating health care costs. One such provision - the Hospital Readmissions Reduction Program, which goes into effect in fiscal year 2013 - will reduce payments ordinarily made to hospitals if they have an 'excess readmission' rate. It is estimated that adverse events following a hospital discharge impact as many as 19% of all discharged patients. When hospitals and similar health care facilities fail to adequately manage the discharge of their patients, devastating medical emergencies and sizeable healthcare costs can result. The urgency to better manage these discharges is compounded by the fact that the average length of hospital stays continues to shorten, potentially increasing the number of discharged patients who are at considerable risk of relapse. Also exacerbating the problem is a lack of clarity regarding who, if anyone, is responsible for these patients following discharge. Confusion over who bears responsibility for discharge-related preparation and community outreach, concerns about compensation, a lack of clear institutional policies, and the absence of legal mandates that patients be properly prepared for and monitored after discharge all contribute to the potential abandonment of patients at a crucial juncture. Although the PPACA establishes financial incentives for hospitals and similar facilities to combat the long-standing problem of high readmission rates, it does not provide a remedy for patients who have suffered avoidable harm after being discharged without adequate preparation or post-discharge assistance. This omission is particularly problematic as existing legal remedies, including medical malpractice suits, have provided little recourse for patients who have suffered injury that could have been prevented through the implementation of reasonable discharge-related policies. To protect the many patients who are highly vulnerable to complications following discharge and to provide them redress when needed services are not provided, hospitals' obligations to these patients should be recognized for what they are: a fiduciary duty to provide adequate discharge preparation and post-discharge services. The recognition of this duty is driven by changes in the nature of hospital care that enhance the perception that hospitals have become a 'big business' that should 'carry their own freight.' Properly interpreted, this duty requires facilities to implement an appropriate discharge plan and provide post-discharge services for a period of time commensurate with a patient's continuing health risks. Notably, this is not the same as a generalized duty to provide all patients with continuing post-discharge treatment. It is a more limited obligation to offer necessary clarification and direction to patients upon discharge, and to institute a reasonable post-discharge monitoring program for patients with continuing health risks. This recognition of hospitals' responsibilities to discharged patients will have a number of beneficial effects. First, it will decrease healthcare costs by reducing the number of patients readmitted with post-discharge complications that could have been avoided through better communication and relatively simple, cost-effective follow-up services. Second, it will reduce confusion in the health care community regarding who is responsible for postdischarge services by affirmatively assigning responsibility to the entities best positioned to provide them, namely hospitals and similar discharging facilities. Third, specifically assigning these responsibilities to hospitals will establish them as a vital component of hospital care, which should help hospitals obtain reimbursement from third-party payors for providing them. Fourth, and most importantly, it will improve the well-being of discharged patients by better preparing them for discharge, increasing the availability of post-discharge services, and providing a means of recourse should they suffer readily preventable injury.
Author: Karen Hertz
Publisher: Springer
ISBN: 3319766813
Category : Medical
Languages : en
Pages : 169
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Book Description
This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030908265X
Category : Medical
Languages : en
Pages : 781
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Book Description
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309391970
Category : Medical
Languages : en
Pages : 95
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Book Description
The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
Author:
Publisher:
ISBN: 9781683086857
Category :
Languages : en
Pages : 546
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Book Description
In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309131529
Category : Medical
Languages : en
Pages : 427
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Book Description
Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309307414
Category : Medical
Languages : en
Pages : 108
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Book Description
The Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors. To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of-and hence compliance with-discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.
