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  • Few Hospitals Violating ‘Good Faith’ EMTALA Requirements for Admitted Patients

    An ED patient is admitted, but then is transferred almost immediately. This kind of situation can call into question whether the admission was “good faith” or if the hospital was just trying to work around federal EMTALA requirements.

  • Legal Implications for ED, Hospital if Triage Nurse Orders Testing

    The authors of a recent analysis examined 13 studies about nurse-ordered testing at triage. Ten studies were about length of stay or time to diagnosis. The authors of the other three compared tests ordered at triage with tests ordered by emergency physicians. There were some surprising findings.

  • Hospital at Home Model Benefits from Traditional QI Approach

    The Hospital at Home care model is gaining favor with hospitals and health systems as a way to provide hospital-level care in a patient’s home while lowering costs by almost one-third and reducing complications. The approach is receiving more attention now as a way to avoid asking patients to come to the hospital during the COVID-19 pandemic.

  • Hospital Reduces HAPI Rate by Half with Huddles, Rounds

    Northwestern Medicine Lake Forest Hospital in Illinois had attempted to reduce hospital-acquired pressure injuries for years, with some success, but hospital leaders remained unhappy with the rate of pressure ulcers. Making changes stick required a change in culture.

  • TJC: Quality Improvement Should Include Data Analysis on Equitable Care

    The COVID-19 pandemic has put a spotlight on the substantial disparities in healthcare that have existed in the United States for many years. The Joint Commission recently issued tips for identifying healthcare disparities and addressing them.

  • TJC Offers Guidance on Accreditation and Effects from COVID-19

    COVID-19 has affected hospitals and health systems in many ways, extending to the accreditation requirements and processes of The Joint Commission (TJC). Responding to many questions and concerns from accredited facilities, TJC recently offered answers in a webinar. The topics were wide-ranging, from the waiver of certain requirements to telehealth and documentation.

  • Watch for Quality Improvement Opportunities in Your Own Department

    An important way to make sure one is operating at peak performance is to see that each project is as efficient as possible. Clinician buy-in often is key to success. Make sure everyone involved with quality improvement, including other departments, knows about the goals.

  • Data Are the Key to Avoiding Claims Denials

    Claims denials have increased by 11% nationally since the onset of the COVID-19 pandemic, according to an analysis. Almost half of claims denials are caused by front-end revenue cycle issues, including registration/eligibility, authorization, or service not covered. Implementing a process to check eligibility at multiple points throughout the revenue cycle will go a long way in preventing this common denial from occurring.

  • Make Patient Access Evaluations More Transparent

    Just as hospitals are becoming more transparent about costs and the quality of clinical care, the same is true for revenue cycle staff performance evaluations. Staff can check on how many registrations they have completed and the accuracy of each. They also can see how the overall department is performing — speed of calls, wait time duration, and how many calls are going to voicemail.

  • More Work Needed to Protect Underinsured Patients

    Poor communication from insurers, a lack of understanding of what patients are purchasing contribute to problem. Early identification of underinsured patients buys time to find solutions.