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When the ED leadership team at Peninsula Regional Medical Center in Salisbury, MD, set out to improve throughput, the first thing they tackled was the line at the door, says Clark Willis, MD, medical director.
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Readmissions among all heart failure patients dropped by 50% in the first year of Saddleback Memorial Medical Center's comprehensive heart failure program, which focuses on a smooth transition between the hospital and the community.
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Recognizing that the transition between the short-term acute care hospital and a long-term acute care hospital (LTAC) is difficult for patients and families, Mesquite Specialty Hospital in Dallas has begun weekly orientation sessions to help family members understand what an LTAC is and how the services a patient will receive there are different from what happens in the short-term acute care hospital.
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Hospital case managers are involved with patients from admission through the entire episode of care and discharge, which puts them in a position to spot patient safety issues and work on ways to prevent them, says John Banja, PhD, professor of rehabilitation medicine, medical ethicist at Emory University's Center for Ethics and director of the Section on Ethics in Research at Emory's Atlanta Clinical and Translational Science Institute.
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As health care reform rolls out, hospitals will be under more pressure to deliver care faster and more efficiently with better outcomes, coordinating care while patients are still in the hospital, and ensuring a smooth transition to the next level of care. And that's where case managers can make a difference, experts say.
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The decrease in the rate of ED patients leaving before treatment at King's Daughters Medical Center in Ashland, KY, from 5% to 0.5% was not achieved by the ED alone. It took a concerted effort on the part of all of the major departments that interface with the ED.
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The best way to prevent hospital readmissions is to make sure patients are better managed and receive the care they need after they leave the hospital, states Donna Zazworsky, RN, MS, CCM, FAAN, vice president of community health and continuum care for Carondelet Health Network in Tucson, AZ.
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"A number of exciting collection technologies have evolved over the last few years.
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Lack of the right technology to automate time-consuming, error-prone processes can put patient access departments at a big disadvantage.
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The Current Procedural Terminology (CPT) code changes in place in the 2008 Physician Fee Schedule improve the ability of physicians and other providers to document their telephone evaluations and management services, but they don't go far enough, according to the Case Management Society of America (CMSA).