One of the key reasons that was found to be a factor in readmissions is that insurance companies continue to push for shorter hospital stays. They have reduced the number of days that they will pay for certain conditions. This was found to be a key factor in releasing patients early, when they might have benefited from a longer hospital stay (Bueno, oss, & Wang et al., 2010; Capelastegui, A,, Espana, P., & Quintana, J. et al., 2008), This factor will have to be considered as a potential barrier to the study. It may be that insurance companies and Medicaid/Medicare reimbursements are a factor in early release of patients rather than hospital practices.

Factors that were identified in other studies of hospital 30-day readmissions included the presence of deep vein thrombosis and pulmonary embolism (Spencer, Gore, & Lessard et al., 2008). Severity scores such as those for community-acquired pneumonia were found…...

mla

References

Bueno, H., Ross, J. & Wang, Y. et al. (2010). Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993-2006. JAMA.

303(21):2141-7.

Capelastegui, A,, Espana, P., & Quintana, J. et al. (2008), Declining length of hospital stay for pneumonia and post discharge outcomes. Am J. Med. 121(10):845-52.

Capelastegui, A., Espana, P, & Chest.Quintana, J.

causes for Medicare and Medicaid patients to be readmitted to hospitals within thirty days of a prior discharge. This is a fairly pervasive and major problem and it is one that demands solutions. As part of this capstone, there will be a number of facets and tools used. There will be a problem description that identifies what the problem is and why it is important. There will be a solution description that broadly asserts what is needed to address and resolve the problem identified. There will be an implementation plan that will lay out how the program will be rolled out to the locations and the people that work therein. There will also be an evaluation plan that will be used to monitor and assess performance so that any deficiencies can be spotted and addressed before they become full-on conflagrations that can sap the performance and outcomes of the…...

mla

References

Challen, L., Kelso, C., & Gandi, B. (2014, May). Association between prescription drug benefit and hospital readmission rates. Hospital Pharmacy, 49, 449-454.  

Hospitals with more elderly, poor patients likely to face readmission penalties" by Katie Sullivan (January 8, 2014)
Are some hospitals discharging patients before they are ready, causing them to be subsequently readmitted? This would seem to be the issue involved in the recent decision by the federal government to assess penalties if hospitals treat so-called "dual-eligible seniors," or those eligible for medical care under both Medicare and Medicaid, because these patients are at higher risk of readmission within 30 days of discharge. According to an article by Sullivan (2014), the reality of the situation is that the majority of the hospitals that will be adversely affecting by this decision are those whose treatment area contains inordinately higher percentages of senior citizens who require a greater share of healthcare resources compared to their younger counterparts. Moreover, the quality of care being provided in these hospitals is not generally at issue. In…...

mla

References

Sullivan, K. (2014, January 8). Hospitals with more elderly, poor patients likely to face readmission penalties. FierceHealthcare. Retrieved from http://www.fiercehealthcare.

com/story/hospitals-more-elderly-poor-patients-likely-face-readmission-penalties/2014-

01-08#ixzz2rBFgdLix.

Psychiatric eadmission
Implementation of Strategies to educe Psychiatric eadmission

To this end, it is clear that hospital readmission remains a prevalent phenomenon in adult psychiatric patients, placing a huge morbidity and economic burden on individuals, families, and healthcare organizations (Burton, 2012; Machado et al., 2012). Addressing psychiatric readmission, therefore, is an important priority for healthcare providers. Evidence demonstrates that psychiatric readmission is mainly caused by ineffective transition of care from the inpatient to the outpatient setting (Kalseth et al., 2016). In essence, reducing psychiatric readmission requires effective care transition interventions. The purpose of this EBP project is to reduce readmissions in an adult psychiatric hospital by 10% over a three-month period.

Implementation Model

There are several models that provide guidelines for the implementation of practice change. In this case, however, given the nature of the clinical setting and resource availability, osswurm & Larrabee's (1999) is deemed an appropriate model. The model suggests six steps…...

mla

References

Burton, R. (2012). Improving care transitions. Health Policy Brief. Health Affairs.

Chugh, A., Williams, M., Grigsby, J., & Coleman, E. (2009). Better transitions: improving comprehension of discharge instructions. Frontiers of Health Services Management, 25(3), 11-32.

Coleman, E., Roman, S., Hall, K., & Min, S. (2015). Enhancing the care transitions intervention protocol to better address the needs of family caregivers. Journal of Healthcare Quality, 37(1), 2-11.

Eassom, E., Giacco, D., Dirik, A., & Priebe, S. (2014). Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors. BMJ Open, 4, e006108.

Quality Improvement Project
Diabetes -- Chronic Condition Background

Type 1 and Type 2 Diabetes

isk factors for type 1 diabetes

isk factors for prediabetes and type 2 diabetes

isk factors for gestational diabetes

The ationale for Selection

The Target Population

Intervention Plans

Target Goals

It has been estimated that in New York there is roughly two million people, or over twelve percent of the population, that have diabetes; furthermore, of this population, over half a million people have the condition but are not aware that they have it (American Diabetes Association, N.d.). It is further estimated that nearly five and a half million people, or over a third of the population, have prediabetes. Diabetes and diabetes-associated cardiovascular diseases have become the leading cause of death in the region accounting for roughly two-thirds of the deaths and the rates of diabetes has lead this trend to be referred to as the diabetes epidemic (Frieden, 2006).

Diabetes does not affect the general population…...

mla

References

American Diabetes Association. (N.d.). Health Disparities. Retrieved from American Diabetes Association:  http://www.diabetes.org/advocacy/advocacy-priorities/health-disparities.html 

American Diabetes Association. (N.d.). New York, New York. Retrieved from American Diabetes Association:  http://www.diabetes.org/in-my-community/local-offices/new-york-new-york/ 

CDC. (2013). Diagnosed Diabetes, Age Adjusted Rate (per 100) Adults - Total 2013. Retrieved from Center for Disease Control:  http://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html 

Department of Health. (N.d.). Diabetes. Retrieved from New York State: https://www.health.ny.gov/diseases/conditions/diabetes/

Healthcare Administration -- New York State Care Act
The New York State Care (Caregiver Advise, ecord and Enable) Act was implemented into law in April this year. The development and enactment of this law is geared toward having a positive effect on caregivers who assist patients and family members recover in the aftermath of hospital admission. The legislation ensures patients in healthcare facilities can assign a family caregiver and the facility provides the designated caregiver instruction and illustrations of medical tasks they are likely to offer their loved ones at home. However, the implementation of this initiative across hospitals such as Winthrop Hospital has been characterized by several challenges that could hinder its effectiveness if not addressed.

New York State Care Act and its Importance/Benefit

There are approximately 2.8 million New Yorkers who offer unpaid care to their loved ones at any given time as well as nearly 1.6 million adult New Yorkers…...

mla

References

Dianoski, T. (2014, November 18). How the New Caregiver Advise, Record, Enable (CARE) Act Affects Hospitals and Health Plans. Retrieved August 11, 2016, from  https://gomohealth.com/2014/care-act-hospitals-health-plans/ 

Kansas Department for Aging and Disability Services. (2015). The Kansas Caregiver Advise, Record, Enable (CARE) Act (HB 2058 and SB 265). Retrieved from Kansas Government website:  https://www.kdads.ks.gov/docs/default-source/CSP/HCBS/HCBS-2015-Spring-Summit/Presentations/the-kansas-caregiver-advise-record-enable -(care)-act-presentation.pdf?sfvrsn=0

Kriss, E. (2015, June 1). AARP: Millions of NY Family Caregivers in Line for Help as Lawmakers Pass CARE Act. Retrieved August 11, 2016, from  http://states.aarp.org/aarp-millions-of-ny-family-caregivers-in-line-for-help-as-lawmakers-pass-care-act/ 

Mitchell, G. (2013, April). Selecting the Best Theory to Implement Planned Change. Nursing Management, 20(1), 32-37.

Hospital SCM
Arnold Palmer Hospital

Managing Service, Processes and Supply Chains

Hospitals and Supply Chains - Overview

Hospital Supply Chains - Advancements

Standard Supply Chain

Stockless Inventory

Vendor Managed Inventory

Consignment

Automated Point of Use Systems

The Next Step in Supply Chain Evolution

Arnold Palmer Hospital Supply Chain

The Arnold Palmer Hospital is one of the country's leading hospitals for women and children. It is located in Orlando, Florida and is currently a part of a national purchasing group in which it utilizes to provide supply chain purchases. Even though being a part of the purchasing group has some cost advantages stemming from the collective bargaining power, there are also many disadvantages that are not entirely consistent with the organizations priorities. These disadvantages can be mitigated by equipping the hospital with more modern supply chain technology. Therefore, an investigation was conducted that identified the supply chain options available for the Arnold Palmer Hospital that would better suit the organizations requirements. Furthermore, it…...

mla

Works Cited

Alverson, C., 2003. Beyond purchasing -- Managing hospital inventory. [Online]

Available at: http://managedhealthcareexecutive.modernmedicine.com/mhe/article/articleDetail.jsp?id=75802

[Accessed 23 September 2011].

Berling, R. & Geppi, J., 1989. Hospitals can cut materials costs by managing supply pipeline. [Online]

eadmission of patients with diabetes is a problem that warrants consideration of the contributing factors. eadmission of patients within 30 days of discharge is considered to be an indicator of healthcare quality -- along with other circumstances, such as patient lifestyle -- that needs to be addressed from a patient care perspective and from a cost of care perspective (Dungan, 2012). A dismal statistic starkly represents the problem: oughly 8% of the U.S. population is represented by patients with diabetes, yet this group accounts for 23% of the hospitalizations in the nation (Dungan, 2012). On top of this figure, between 14.4% to 21% of diabetic patients are readmitted, compared to 8.5% and 13.5% of U.S. hospital patients overall (Dungan, 2012). The problem is exacerbated by the rise in national rates of diabetes means that more patients will present from the general population and, accordingly, more patients with diabetes will experience…...

mla

References

Donnell-Jackson, K., Ram M. Jhingan, R.M. And Rubin, D.J. (2013). Early Readmissions among hospitalized patients with diabetes: A qualitative assessment of contributing factors. Paper presented at Diabetes: Diagnosis, Complications & Outcomes, The Endocrine Society's 95th Annual Meeting and Expo, from June 15 -- 18, 2013, in San Francisco, California.

Dungan, K.M. (2012, September). The effect of diabetes on hospital readmissions. Journal of Diabetes Science Technology, 6(5), 1045-1052. Retreived from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570838/ 

Dye, J. G, Schatz, I.M., Rosenberg, B.A., and Coleman, S.T. (2000, January). Constant comparison method: A kaleidoscope of data. The Qualitative Report, 4(1/2).

Hellman, R. (2014, October). An individualized inpatient diabetes education and hospital transition program for poorly controlled hospitalized patients with diabetes. Endocrine Practice, 20(10), 1097-1099.

Quality Indicator
Healthcare Quality Indicators

ith the adoption of the Affordable Care Act, also now commonly referred to as Obamacare, the array of quality indicators used to assess healthcare facility performance has expanded. The addition of a number of quality indicators with direct connections to penalties and other punitive measures has created a great deal of pressure for hospitals and other healthcare facilities. Many of these quality indicators are designed to heighten accountability among hospitals and other acute healthcare treatment cites or systems. Among them, penalties for preventable readmissions has become an exceptionally prominent indicator of performance quality.

Quality Indicator:

According to Brink (2013), the quality indicator of readmission rates has become an important issue for healthcare leaders and hospital administrators. Brink reports that roughly 12% of all Medicare patients will be readmitted to the hospital within the first 30 days of discharge for recurrent conditions that could be prevented through better treatment and…...

mla

Works Cited:

Brink, S. (2013). Hospitals Seek to Avoid Penalties by Minimizing Readmissions. U.S. News and World Report.

Johnson, M. (2013). For Hospitals, Obamacare Rollout Makes Readmission Penalties a Top-of-Mind Priority. NJ Biz.

Rau, J. (2013). Medicare Revises Readmissions Penalties -- Again. Kaiser Health News.

If a hospital has a poor record of infections and patient falls, those patients who have a choice will avoid the hospital. So, as the hospitals begin recording and tracking the information, those that do not choose to improve lose patients (HQA 2011). Contrary wise, those hospitals that remain on the cutting edge of improving the quality of care for patients are hospitals that will be sought after by patients who have an option.
Another possible reason for the desire to improve conditions is for the sake of attracting better physicians. Many physicians are selective as to the hospitals they serve with. For instance, most Catholic physicians tend to only seek admission to Catholic hospitals.

It is possible that hospitals may seek reimbursement as a means of dealing with quality issues with patients. Currently, when a hospital makes a mistake the patient is still expected to pay the full amount for…...

mla

Works Cited

Hospital Quality Alliance (2011). Quality Measures. Extracted February 4, 2012.  http://www.hospitalqualityalliance.org/hospitalqualityalliance/qualitymeasures/qualitymeasures.html 

Washington State Hospital Association (2011). Quality Indicators Search Page. Extracted February 4, 2012. http://www.wahospitalquality.org/index.php

Myocardial Infarction Minimizing Hospital Readmission Phase 1: EBP for Effective Patient Care Transition
Donald, an acute myocardial infarction (MI) patient, has undergone angioplasty, a procedure in which a catheter is inserted into clogged arteries in a patient’s heart to widen them and improve blood flow. To supplement the angioplasty, Donald has had cardiac stents placed to prop the affected arteries open and reduce their risk of narrowing again. Studies have shown that several complications could result from angioplasty procedures and the insertion of stents as in Donald’s case. The most common complications include bleeding or vascular complications (6 percent of patients), acute renal failure (5 percent of patients), and stroke (0.3 percent of patients) (Dunlay et al., 2012). A study analyzing readmission rates among MI patients in Minnesota found that bleeding was the most common complication after angioplasty, affecting 6 percent of patients (Dunlay et al., 2012). The most common form of…...

mla

References

Borghi, C., & Ambrosioni, E. (1996). Primary and Secondary Prevention of Myocardial Infarction. Clinical and Experimental Hypertension, 18(3), 547-58.

CMS (n.d.). Guide to Reducing Disparities in Readmissions. Center for Medicare and Medicaid. Retrieved from  

Dunlay, S., Weston, S. A., Killian, J., Bell, R. M., Jaffe, A. S., & Roger, V. L. (2012). Thirty Day Hospital Readmissions Following Acute Myocardial Infarction: A Community Study. Ann Intern Med, 157(1), 11-18.

Jones, R., Arps, K., Davis, D. M., Blumenthal, R. S., & Martin, S. S. (2018). Clinician Guide to the ABCs of Primary and Secondary Prevention of Atherosclerotic Cardiovascular Disease. American College of Cardiology. Retrieved from  https://www.acc.org/latest-in-cardiology/articles/2018/03/30/18/34/clinician-guide-to-the-abc s

Karunathilake, S. P., & Ganegoda, G. (2018). Secondary Prevention of Cardiovascular Diseases and Application of Technology for Early Diagnosis. Biomed Research International, doi: org/10.1155/2018/5767864

Lambert, P., Chaisson, K., Horton, S., Petrin, C,…& Brown, J. (2017). Reducing Contrast-Induced Acute Kidney Injury: How Nurses can Improve Patient Safety, a Qualitative Investigation. Critical Care Nursing, 37(1), 13-26.

https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Readmissions_Guide.pdf 

PPACA
On March 23, 2010 the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. Along with the Health Care Reconciliation Act of 2010, the PPACA became part of the overall Health Care Reform concept of 2010. The health care reform process was promoted as a way to completely transform the health care industry and ensure that all Americans received affordable health care. hile supporters praise the legislation as a revolutionary law which will benefit ordinary Americans, critics claim that the Obama Administration used the health care reform process as a means of gaining control over the entire health care system. In an attempt to compare and contrast the provisions of this new law, this essay will discuss several provisions of the new health care legislation and compare the benefits as well as the criticisms of them.

Section 5501 of the PPACA provides for Medicare…...

mla

Works Cited

Appleby, Julie. (2011, Jan. 10). Effort To Reward Medicare Advantage Plans Draws Criticism. Kaiser Health News. Retrieved from  http://www.kaiserhealthnews.org/Stories/2011/January/10/Medpac-on-Medicare-Advantage-bonuses.aspx 

"Side Effects: Obamacare Could Punish Docs for Better Quality Care." (2010, July 16). The Heritage Foundation. Retrieved from http://fixhealthcarepolicy.com/health-care-news/side-effects-obamacare-could-punish-docs-for-better-quality-care/

Gold, Jenny. (2011, Jam. 18). "Accountable Care Organizations, Explained." NPR. Retrieved from  http://www.npr.org/2011/04/01/132937232/accountable-care-organizations-explained 

"Health Care Reform: Annual Fee on Prescription Drug Manufacturers and Excise Tax on Medical Devise Manufacturers." (2010, Apr.). Covington & Burling LLP Retrieved from  http://www.cov.com

EBP is to facilitate strategy to eradicate short cycle return to second readmission of psychiatric patients on hospital beds. Doing so will assist health care providers in addressing the issue of bed shortage. eduction of readmission rates allows more space to be available for other patients and helps to cut costs as well as bring about better conformity with governmental regulations.
Search Process

The search process used in this literature review began with searching key words in online databases such as Cochran eview, CINAHL, and other nursing research journal databases. Google Scholar was used as the primary search engine, with filters set to permit results from these particular databases. Key words used included "reducing readmission rates," "readmission psych," "causes of readmission psych hospital," "psych hospital readmission," "reduction of psych readmission," and other combinations of key words identified by relevant articles found after conducting these searches. More than a thousand articles were…...

mla

References

Burns, T., Rugkasa, J., Molodynski, A. et al. (2013). Community treatment orders for patients with psychosis (OCTET): A randomized controlled trial. The Lancet, 381(9878): 1627-1633. DOI:  

Summary of Two Articles1: Quantitative StudyHospital eadmission Performance and Patterns of eadmission: etrospective Cohort Study of Medicare AdmissionsProblem StatementThe problem that is addressed by Dharmarajan, Hsieh, Lin et al. (2013) in their quantitative study is that too little is known regarding the relationship between hospital rates of readmission and the diagnoses and timing of readmissions. By better understanding this relationship, the researchers hypothesize that more effective approaches to lower readmission rates may be deduced.Statement of PurposeThe researchers identify their objective within the study in the following terms: To determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions (Dharmaraian et al., 2013, p. 1).esearch Question(s)/HypothesisThe research questions that the researchers pose are two-fold: 1) Does the spectrum of…...

mla

ReferenceTzeng, H. M., Yin, C. Y., Anderson, A., & Prakash, A. (2012). Nursing staff’s awareness of keeping beds in the lowest position to prevent falls and fall injuries in an adult acute surgical inpatient care setting. Medsurg Nursing: Official Journal of The Academy of Medical-Surgical Nurses, 21(5), 271-274.

Amin, B et al. (2013). Pitfalls of calculating hospital readmission rates based on nonvalidated administrative data sets. Journal of Neurosurgery: Spine, 18(2): 134-138.
This study examines the University of California's Medical Center in San Francisco in order to determine if its all-cause readmission rates accurately reflect the readmission rates for spine injury patients. The secondary purpose of the study is to identify readmission predictors. The researchers collected data from 5780 consecutive patient visits. 5% of the visitors were readmitted within a month of their discharge. The researchers examined variables that led to their readmission and regression analysis was conducted in order to spot predictors. A t-test was also used to see if there was any difference in admission vs. non-readmission incidents. The researchers found that infection was the number one variable leading to readmission, inoperable management the second most common variable, and planned surgery the third most common variable for…...

mla

Kachalia, A. (2013). Improving patient safety through transparency. New England

Journal of Medicine, 369: 1677-1679.

This study provides a qualitative review of why transparency is helpful in health care. The researcher shows that openness with patients and clinical health care providers is essential to maintaining a relationship of trust, accountability, and of improving patient safety. The more forthcoming with information that health care providers are with patients, the more forthcoming patients are likely to be with their providers. The research indicates that many health care organizations are still behind the curve when it comes to developing a workplace culture that actively promotes and facilitates transparency. The study indicates that a principled and formal approach to addressing errors in disclosure would go a long way in supporting a culture of transparency. This study is helpful in identifying an issue in nursing that requires attention for the good of both patient and practitioner.

Accountable Care Organizations (ACOs) like AdventHealth aim to improve healthcare quality by enhancing care coordination, reducing unnecessary spending, and focusing on preventative care. Metrics often used to evaluate their impact include patient satisfaction scores, hospital readmission rates, and the management of chronic conditions. ACOs are compared through benchmarks in these areas, cost savings, and quality of care improvements.

Determining the impact of AdventHealth ACO on healthcare quality and metrics requires a deep dive into several factors. Here's a breakdown of key aspects to consider:

Metrics used for evaluation:

• Healthcare Effectiveness Data and Information Set (HEDIS) scores: These standardized measures assess preventive....

Integrating Health and Social Care Services: Enhancing Patient Outcomes and Quality of Life

Integrating health and social care services has emerged as a paramount strategy to enhance overall patient outcomes and improve their quality of life. By seamlessly connecting medical and social support systems, integration addresses the multifaceted needs of individuals, fostering a comprehensive approach to well-being.

Improved Patient Outcomes:

Enhanced Care Coordination: Integration eliminates the silos between health and social care providers, enabling them to collaborate effectively in developing and implementing patient-centered care plans. This ensures that patients receive the most appropriate services at the right time, reducing gaps and overlaps....

Social Care Interventions for Improved Health Outcomes in Marginalized Communities

Marginalized communities experience a disproportionate burden of health disparities due to systemic barriers and inequities. Social care interventions play a crucial role in addressing these inequities and improving health outcomes by targeting the root causes of poor health.

Multi-Faceted Approach to Improve Determinants of Health:

Social care interventions adopt a comprehensive approach to improve the social determinants of health, which include factors such as:

Economic stability: Providing financial assistance, job training, and affordable housing to reduce economic stress.
Social support: Strengthening social networks, promoting community engagement, and providing access to mental health support.
....

One way to use technology for better patient care is by implementing predictive analytics. By analyzing large amounts of data, healthcare providers can identify patterns and trends that may lead to potential health issues. This can help in predicting and preventing adverse events, such as medication errors or hospital readmissions.

Another way technology can improve patient care is by giving patients digital access to their health records. This allows patients to have more control over their own healthcare information and enables them to easily share this information with different healthcare providers. Having access to their health records can also help patients....