The American Academy of Case Management

Revealing the Best-Kept ‘Secret’ of Case Management from Nurse Together

noreply@blogger.com (Unknown) — Fri, 16 Mar 2012 16:14:00 +0000

Amidst all the talk about how to improve quality, efficiency and efficacy in healthcare these days, case management sometimes feels like the best kept secret. Those of us in the field know without question the difference that case management makes to those for whom we advocate, in particular patients with complex cases or multiple co-morbidities. Yet at times case management seems to occupy an understated position while newer and sometimes nearly synonymous terms such as care coordination take the spotlight.

To understand why, we need not look beyond ourselves.

Clarity in Definition

Across the spectrum of health and human services, case management is made up of professionals who, by their nature and vocation, are nurturers and caregivers. We expend so much emotional energy giving to others that self-promotion seems both unnatural and too much work. Few of us have the extra energy it takes even to contemplate the difference we make to our patients, employers, profession and community.

For the full article please go here.

Cancer Care Outcomes Better In Specialized Cancer Centers from Medical News Today

noreply@blogger.com (Unknown) — Thu, 15 Mar 2012 16:35:00 +0000

In a review of recent studies, researchers from The Cochrane Library, reveal that specialized cancer centers may help improve survival rates for cancer patients. ,The team discovered that when women with gynecological cancer were treated in specialist centers, they lived longer than those treated in non-specialist cancer centers.

Previously, non-specialist surgeons and hospitals frequently treated individuals with cancer. At present, most cancer care in developed countries is organized into networks of specialized cancer centers. These centers have specialized nursing staff, as well as on-site experts. Even though this centralized strategy is more expensive it could improve outcomes for cancer patients.

The researchers examined data from 5 studies, involving over 62,000 women who received treatment from the late 1990s onwards. The largest study, conducted in 2009, involved more than 48,000 women, whilst the smallest study involved only 250 participants.

For the full article please go here.

Health Care Negligence Affecting Hospitalized Patients from Medical News Today

noreply@blogger.com (Unknown) — Tue, 13 Mar 2012 13:35:00 +0000

A recent study, published on bmj.com, states that although lack of necessary hospital equipment and low staff numbers cause problems in the overall well-being of a hospital, insubstantial teaching, low monitoring of staff practices, and workers not following hospital regulations are far more detrimental to the health and treatment of patients in hospitals.

The study claims that an estimated 1 patient per day in a hospital dies due to the negligence of hospital staff. The study claims these deaths could have, and should have been prevented.

During their study, the researchers from the New York City Health and Hospital Corporation analyzed 25 hospitals spreading from Tunisa, Sudan, South African, Yemen, Egypt, Jordan, Kenya and Morocco. They determined that although patients in hospital are obviously admitted because they are sick, many times, patients die because of poor health care, and not actually the health problem they were admitted for.

For the full article please go here.

Surviving Modern Healthcare: Personal Branding from Nurse Together

noreply@blogger.com (Unknown) — Fri, 09 Mar 2012 17:03:00 +0000

If asked you what “just do it” means, you would say that is the slogan for Nike. If I said, “Like a good neighbor…” you probably could finish the sentence “State Farm is there.” These are brands that companies have created for themselves to make their products and services memorable. A successful brand can charge a premium. Whoever thought that a company like Starbucks could get 5 dollars for a cup of coffee? Positive perception of a brand begins with a good experience. Think about drinking an ice cold branded beverage like a Pepsi or Coke. What do you think about? Probably how good it tastes and how refreshing it feels while you are drinking it. If you don’t like those two I suggest substitute with your favorite.

For the full article please go here.

Medicare covers yoga for heart disease from CNN

noreply@blogger.com (Unknown) — Mon, 27 Feb 2012 17:34:00 +0000

CNN) -- Frank Korona lives near the West Virginia-Pennsylvania border with his wife Kathy, in a house that he built with his own hands, on the same property where he grew up.

He served in the Army Special Forces in Vietnam. The Koronas have a long, proud tradition of military service, but their family's greatest losses have been to heart disease.

"Our family has shrunk tremendously. We've lost so many people through death," Kathy says.

In 1992, Frank's brother Bob died in his arms, suffering a heart attack on their kitchen floor. Parents, siblings, aunts, uncles and cousins have all died from complications from heart disease, too. The Koronas point them out in a graveyard near their home.

For the full article please go here.

Patient Recruiters and the Anatomy of Healthcare Scam from Nurse Together

noreply@blogger.com (Unknown) — Mon, 27 Feb 2012 16:31:00 +0000

Healthcare scams are constantly evolving and costing tax payers billions of dollars, most of which will probably never be recovered. The U.S. Department of Health and Human Services’ strike force operations have obtained over 1,000 indictments for individuals who have fraudulently billed Medicare for more than $2.3 billion since March 2007.

A healthcare scam is the premeditated fraud carried out by a provider, hospital, clinic, employer group, member, or other group or individual for illegal financial gain. Fraud takes many forms, and can involve what are known as “cappers,” or patient recruiters who literally recruit patients to become part of a healthcare scam designed to bilk millions out of the Medicare program.

For the full article please go here.

Case Managers: How Can You Enrich Your Patient's Life? from Nurse Together

noreply@blogger.com (Unknown) — Wed, 22 Feb 2012 17:47:00 +0000

One of the key outcomes case managers strive to achieve is an improved quality of life for the patients they work with. Yet many of the services that can improve a patient’s quality of life may not be reimbursable by traditional payment systems. To get a feel for the impact of this statement, think about the things that you depend on for enjoyment. Things like the ability to dress independently, to drive a car, to gather with friends for a glass of wine, access to cable television, the means to go to a baseball game, movie or a take a vacation.

We all have things that enrich our lives and they are as individual as we are. Yet for the person who is disabled, access to many of these things may be a challenge and take creativity to achieve. Families who have a member who is disabled are the key advocates for their family members. Many are the voice of the person and work to ensure that their family member is included and that accommodations be made if necessary to allow them to participate. Families may also be able to pay for things that we all take for granted, but with expenses mounting for necessities, sometimes funds are limited and have to be put aside.

For the full article please go here.

Readmissions Reporting Methods Explained from Nurse Together

noreply@blogger.com (Unknown) — Mon, 20 Feb 2012 16:55:00 +0000

Targeting and reducing hospital readmission rates has become a top priority for the Medicare program, and beginning in October, the Patient Protection and Affordable Care Act will start slashing payments to hospitals with higher than average readmission rates under the new fee-for-service program.

The need for proven readmission strategies has never been more urgent with the regulation taking effect later this year. In fiscal year 2013, the payment decrease can be up to one percent of Medicare reimbursement, rising to two percent in 2014 and three percent in 2015.

A new working paper published in January by America’s Health Insurance Plans, the industry group that represents health insurance companies, says there are many ways to measure readmission rates, some of which may be suitable for certain purposes but not others.

For the full article please go here.

Scientists Repair Heart Attack Damage Using Patient's Own Stem Cells To Regrow Healthy Heart Muscle from Medical News Today

noreply@blogger.com (Unknown) — Tue, 14 Feb 2012 16:29:00 +0000

Details of a small clinical trial published in The Lancet on Tuesday reveal how scientists helped patients with hearts damaged by heart attack to re-grow healthy heart muscle and reduce scar tissue with an infusion of stem cells taken from the patients' own hearts.

Leading international cardiologist and heart researcher Dr Eduardo Marbán, who is director of the Cedars-Sinai Heart Institute in Los Angeles and Mark S. Siegel Family Professor, is senior author of the study. He told the press what they saw in the trial:

"... challenges the conventional wisdom that, once established, scar is permanent and that, once lost, healthy heart muscle cannot be restored."

For the full article please go here.

Are You Standing in the Way of High Performance? from H and HN

noreply@blogger.com (Unknown) — Wed, 08 Feb 2012 18:13:00 +0000

PHOENIX— It's possible, Michael Frisina postulated, that when your hospital developed its strategic plan for the coming year, it actually validated a policy that said a certain percentage of your patients will be harmed. If zero errors aren't the goal, Frisina said during a keynote yesterday at the 25th Annual Rural Health Care Leadership Conference, then you're acknowledging that patients will be harmed.

"We say that patient care comes first and the patient is at the center of our care delivery," said Frisina, head of a self-named consulting firm and senior research scholar at The Center for Influential Leadership. "When are we really going to do that?"

Much like Bridget Duffy's presentation the day before, Frisina made the case that all too often our own behaviors stand in the way of us — and our organizations — from achieving more. His most critical assessment was aimed at the C-suite: Leaders set the tone. Their behavior will determine whether an organization strives for high-performance and compassionate care.

For the full article please go here.

The New Health Reform Bill: Do You Know How It Will Affect You? from Nurse Together

noreply@blogger.com (Unknown) — Wed, 08 Feb 2012 18:09:00 +0000

Unprecedented evolution of the health system in our country is beginning with the institution of the new health care bill. Over one thousand pages of legal-ease have made it virtually impossible for anyone to understand the changes and far less a chance to predict the outcomes. Most hospitals and healthcare organizations have appointed entire legal teams to attempt to assess the effects of this new legislation on their organizations. There are also many potential effects on the nursing profession that in some cases may be an advantage. Some could also be problematic. To attempt to predict the effects of the bill on nursing, let us attempt to explore the bill in simple terms.

There are three main problems with the current health system that this bill will attempt to address. These include rising costs secondary to insurance premiums and aging population, holes in coverage for most people with preexisting conditions, lifetime limits on benefits and rising costs to employers who are reducing coverage and individuals without access to healthcare at all. The bill will be phased in over time beginning now. The following will be the highlights of each phase.

For the full article please go here.

Employing Docs Without a Strategy? Think Again from H and HN

noreply@blogger.com (Unknown) — Wed, 08 Feb 2012 18:07:00 +0000

Click here to view and excellent video on doctor hiring strategies.

Reducing Hospital Readmissions from H and HN

noreply@blogger.com (Unknown) — Thu, 02 Feb 2012 18:37:00 +0000

The Centers for Medicare & Medicaid Services have been focusing on reducing acute care readmissions within 30 days of discharge through its Hospital Readmissions Reduction Program. Hospitals with higher than expected 30-day readmission rates will incur penalties against their total Medicare payments beginning in federal fiscal 2013.

Commercial payers likely will follow suit, as organizations such as the Joint Commission, Partnership for Patients and the National Quality Forum support this program.

To meet the challenge, hospitals need to take a structured approach to reducing readmissions — an assessment of the organization's risk and a comprehensive strategy that transitions the patient from the hospital to post-hospital care.

For the full article please go here.

In Focus: Rural Health from H and HN

noreply@blogger.com (Unknown) — Thu, 02 Feb 2012 18:35:00 +0000

Last month, regular H&HN Daily contributor Ian Morrison wrote a compelling column (aren't they all?) on reinventing rural health. In it he discussed the multitude of challenges facing rural providers — staff shortages, payer mix, capital and IT gaps, and more. The column also spends a fair amount of time discussing the hurdles rural providers will face as we move to a value-based, accountable care system.

In a bit of an understatement, he wrote: "Rural health is tough to manage, from both a policy and practical point of view." But he's then quick to note: "As we redesign the overall health care delivery system from volume to value, we raise the question of what happens to rural health care. While the challenges described here are real, in my travels I detect a growing openness to reinvention of rural health among community leaders and hospital CEOs across the country."
I couldn't agree more. I'm always amazed by the can-do attitude exhibited by rural health care leaders. They approach the hurdles in front of them head on, knowing that in so many cases they are the lifelines of their communities. That's part of the reason that I'm eager to board a plane Saturday afternoon and head to Phoenix for the 25th Annual Rural Health Care Leadership Conference. Year in, year out, it is one of my favorite meetings (and I'm not just saying that because it's our meeting).

For the full article please go here.

States Under Pressure As Health Law Deadlines Approach from Kaiser Health News

noreply@blogger.com (Unknown) — Thu, 02 Feb 2012 17:43:00 +0000

The health law's biggest changes don't take effect until 2014, when states and insurers must be ready to begin signing up an estimated 32 million people in Medicaid and private insurance. But a successful rollout in two years hinges on critical decisions that states must make – and take quick action on – this year.

It will be difficult for many states to meet fast-approaching deadlines, and some may not make it, says Brett Graham, a managing director at Leavitt Partners, a consulting firm working with states on implementation of the law.

Time is short, and states are missing key pieces of how-to guidance from the federal government about everything from what various insurance exchange options will look like to which benefits must be included in health plans, he says. To make matters worse, states are competing for a limited pool of information technology vendors to help them get started.

"It's a pressure cooker," said Graham. States are "in a position where they have to act with imperfect information."

One of the most pressing tasks for states this year has to do with the creation of exchanges, through which individuals and small businesses can buy insurance starting in 2014.

For the full article please go here.

Riding Herd on the Silver Stampede from H and HN

noreply@blogger.com (Unknown) — Wed, 01 Feb 2012 19:49:00 +0000

Are you ready for the "Silver Stampede?" That's the question contributing editor Geri Aston asked hospital leaders in her December Hospitals & Health Networks article on the onslaught of older patients, which will have — indeed, already is having — an enormous impact on our health care system. Like most of the stories we run in H&HN, the focus of Geri's article was on real-world solutions — positive, practical ways health care organizations are confronting a difficult issue, in this case senior care, so that other hospital leaders can decide whether those strategies might be worth adapting in their own organizations.

I write frequently in this space about generational issues in health care, and after Geri's article ran, I heard from a number of readers wanting to let me know that they and their colleagues also are taking creative steps to confront this issue. Here are four you might find interesting and useful:

For the full article please go here.

Medication Errors In Hospitals Reduced By e-Prescribing from Medical News Today

noreply@blogger.com (Unknown) — Wed, 01 Feb 2012 18:44:00 +0000

A study published in this week's PLoS Medicine shows that commercial electronic prescribing systems (commonly known as e-prescribing, in which prescribers use a computer to order medications for their patients through a system with the help of prompts, aids, and alerts) could substantially reduce prescribing error rates in hospital in-patients.

In the study, led by Professor Johanna Westbrook from the University of New South Wales in Sydney, Australia, the authors studied the introduction of the Cerner Millennium e-prescribing system into one ward in one hospital (Hospital A), and used three other wards as controls. At another hospital, the authors compared the error rates on two wards before and after the introduction of the e-prescribing system iSoft MedChart.

For the full article please go here.

New Health Care Articles Blog

noreply@blogger.com (Unknown) — Tue, 31 Jan 2012 17:08:00 +0000

Please visit our new "health care articles" BLOG

access

We are accepting articles for review and consideration for publication on our Blog.
Email inquiries to: info@aihcp.org

Doctor, Did You Check Your Checklist? from Kaiser Health News

noreply@blogger.com (Unknown) — Mon, 30 Jan 2012 17:41:00 +0000

When Frances Barnes had a stroke in August 2008, she was taken by ambulance to Howard University Hospital. The 80-year-old grandmother was there for about two weeks when she began complaining about pain in her legs. Her daughter Althea Hart pulled back her mother’s blankets and noticed a strange odor.

Hart thought the smell was coming from the compression stockings wrapped around Barnes’s legs to help with circulation, so she took them off. She found that her mother’s left foot had turned black.

Hospital staff had failed to follow physician orders, which required taking off the compression stockings after each shift for at least 30 minutes, according to a DC Department of Health investigation.

"We called a nurse right away, and they tried to heal her infection," says Patricia Moss, another of Barnes's daughters. "But they couldn't."

For the full article please go here.

Protecting Yourself from Hospital Complications from Bettermedicine.com

noreply@blogger.com (Unknown) — Mon, 30 Jan 2012 16:43:00 +0000

Protecting Yourself from Hospital Complications

People are born, mended, and consoled in hospitals, hopefully without incident and undue harm. Doing no harm is the ethical guiding principle of doctors, nurses and hospitals. It is what we, as patients and consumers of healthcare, hope for the moment we walk through the hospital door.

But not all hospitals are created equal and on occasion complications arise – in both good and inadequate medical facilities.

What Is a Hospital Complication?

A hospital complication is any condition that arises while you are in the hospital that is unlikely to be related to your condition when you were first admitted. Complications often prolong your stay or cause you to be readmitted to the hospital. One measure used as a marker to evaluate hospital effectiveness is to compare complication rates among hospitals side by side. In this way, you can determine if one hospital has more or less complications than another hospital for a specific procedure or surgery.

For the full article please go here.

Electronic Medical Records Still Need Work, Report Says from Huffington Post

noreply@blogger.com (Unknown) — Mon, 30 Jan 2012 15:55:00 +0000

WASHINGTON — America may be a technology-driven nation, but the health care system's conversion from paper to computerized records needs lots of work to get the bugs out, according to experts who spent months studying the issue.

Hospitals and doctors' offices increasingly are going digital, the Bipartisan Policy Center says in a report being released Friday. But there's been little progress getting the computer systems to talk to one another, exchanging data the way financial companies do.

"The level of health information exchange in the U.S. is extremely low," the report says.

At the consumer level, few people maintain a personal health record on their laptop or electronic tablet, partly due to concerns about privacy, security and accuracy that the government hasn't resolved.

"How will sensitive health data be kept confidential and secure in digital data-sharing environments?" the report asks. "Many consumers ... are waiting for a reassuring answer to this question."

For the full article please go here.

5 Common Marketing Blunders that Health Care Providers Make from Nurse Together

noreply@blogger.com (Unknown) — Fri, 27 Jan 2012 20:23:00 +0000

Most health care providers who have a clinical practice, or any type of business where they rely on clients, will need to market in order to sustain and grow that practice and business. While knowing how to market is essential, it's also just as valuable to know what you should not be doing when you are marketing. Today let's focus on the five of the most common marketing blunders I see health care providers make.

For the full article please go here.

Data: Medicaid Eligibility Remained Stable in 2011 from H and HN

noreply@blogger.com (Unknown) — Fri, 20 Jan 2012 17:55:00 +0000

The number of Americans eligible for Medicaid or the Children's Health Insurance Program remained relatively stable in 2011, a new report from the Kaiser Commission on the Uninsured finds. The report found that 11 states expanded eligibility for Medicaid or CHIP in 2011, which was attributed in part to Affordable Care Act provisions that require states to maintain existing coverage. Eight states expanded eligibility for children, while three offered increased coverage of parents and other adults.

Among the other findings:

For the full article please go here.

Using Evidence to Motivate Hospital Employees from H and HN

noreply@blogger.com (Unknown) — Thu, 19 Jan 2012 17:49:00 +0000

All too often, we miss out on opportunities to learn from another area of our business. One clinical approach that can be emulated throughout the hospital is evidence-based practice, which integrates current research, caregiver perspectives and experience, and patient preferences. [For more information, see Evidence-Based Practice in Nursing & Healthcare by B. Melnyk and E. Fineout-Overholt;Philadelphia, Lippincott Williams & Wilkins, 2005.]

Physicians and nursing professionals have been using EBP in various forms since the 1970s to improve patient care outcomes. Its longevity is due to its documented success in many different areas, including infection prevention and patient falls.

In more recent years, scholars have studied and written about evidence-based leadership and evidence-based management. A logical progression in this thinking is evidence-based employee engagement. Employees are engaged when they are satisfied (they like what they do), energized (they put effort behind it) and productive (their work contributes to organizational goals). Leaders who are effective in engaging others are facilitators of the engagement process. Because no one external source can motivate an employee, providing an environment that encourages intrinsic motivators is critical.

For the full article please go here.

The KHN Conversation: 'Innovation' Advisors On Achieving CMS' Triple Aim from Kaiser Health News

noreply@blogger.com (Unknown) — Thu, 19 Jan 2012 17:24:00 +0000

One of the more controversial, yet least expensive, aspects of the health law is starting to kick in.

The Centers for Medicare and Medicaid Services has launched the Innovation Center, which is supposed to experiment with different ways to deliver health care more efficiently. As one of its first initiatives, the center has selected 73 people to be “Innovation Advisors.” Their year-long commitment with CMS' Innovation Center requires they test out an idea -- with the goal of improving health, improving quality of care and decreasing costs -- and, if successful, could see it scaled up by CMS.

Among those first selected to receive grants of as much as $20,000 are doctors, nurses, hospital executives, public health and policy experts, and they represent institutions in 27 states plus the District of Columbia. CMS expects to pick as many as 200 advisors by the end of the year.

For the full article please go here.