92+ documents containing “hospital readmission”.
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….
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….
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….
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….
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….
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….
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….
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….
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….
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….
Patient Eduation
Patients eduation
Patient eduation an be desribed as a proess by whih majorly health professionals and other related stakeholders impart information to patients together with their aregivers so that there an be improvement of health status and also alter health behavior of patients. Those who may be involved in health eduation may inlude physiians, pharmaists, registered nurses, psyhologists, speial interest groups, and pharmaeutial ompanies. Health eduation an also be used as a tool by managed are plans in general preventative eduation and health promotion. Some of the important elements that are supposed to be onsidered when dealing with patient eduation are skill building and responsibility. It is neessary for patients to know why, when and how they are required to make their lifestyle hange. This proess of patient eduation is apable of reduing healthare osts.
Looking at studies pertaining ost ontainment, it shows that patient eduation results to a signifiant savings.….
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….
Evidence-Based Practice Project: educing ate of Psychiatric eadmission
The purpose of the evidence-based practice project is to examine ways to eliminate psychiatric readmissions. More specifically, literature is reviewed to examine evidence supporting the effectiveness of care transition interventions in preventing re-hospitalization amongst adult patients with severe mental illness. In this chapter, the search process is first described. Next, the identified literature is summarized and synthesized, clearly evaluating the relevance of the literature to the specified PICOT question.
Search Process
Literature for the review was searched in CINAHL, PubMed, EBSCO, ProQuest, and Google Scholar databases using the following phrases: psychiatric readmission, re-hospitalization, care transition interventions, transitional care interventions, and reducing readmission in adults with mental illness. Focus was particularly on literature published in English. From the first round of search, it was quite evident that not much scholarly attention has been given to the topic as the search returned less than 1,500 hits. The….
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….
Lagoe, R.J., et. al. (13 Aug 1999) "Analyzing hospital readmissions using statewide discharge databases." Nursing Care Quarterly 13(6): 57-67.
Why did the authors select hospital readmissions as a way to evaluate the quality of care for these DRGs?
In contrast to simply measuring the patient's lengths of stay, the swiftness or slowness of patient discharge rates, lengths of patient occupancy, or patient mortality, measuring hospital readmissions rates were through to be an effective means of evaluating quality of care. The readmissions rate specifically measures treatment efficiency, namely that readmission often occurs when a condition that was not likely to have been treated during the patient's first stay of occupancy. In other words, length of stay by definition is affected by the patient's severity of illness -- the fact that a hospital might treat more children with broken legs (necessitating overnight stay) than chicken pox (not necessitating overnight stay) is not a determinative….
Healthcare
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…
Read Full Paper ❯Health - Nursing
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…
Read Full Paper ❯Healthcare
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…
Read Full Paper ❯Nursing
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…
Read Full Paper ❯Healthcare
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…
Read Full Paper ❯Health
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…
Read Full Paper ❯Health - Nursing
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…
Read Full Paper ❯Nursing
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…
Read Full Paper ❯Healthcare
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…
Read Full Paper ❯Healthcare
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…
Read Full Paper ❯Healthcare
Patient Eduation Patients eduation Patient eduation an be desribed as a proess by whih majorly health professionals and other related stakeholders impart information to patients together with their aregivers so that…
Read Full Paper ❯Healthcare
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…
Read Full Paper ❯Health - Nursing
Evidence-Based Practice Project: educing ate of Psychiatric eadmission The purpose of the evidence-based practice project is to examine ways to eliminate psychiatric readmissions. More specifically, literature is reviewed to examine…
Read Full Paper ❯Nursing
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…
Read Full Paper ❯Healthcare
Lagoe, R.J., et. al. (13 Aug 1999) "Analyzing hospital readmissions using statewide discharge databases." Nursing Care Quarterly 13(6): 57-67. Why did the authors select hospital readmissions as a way to…
Read Full Paper ❯