Posts tagged 'hospital'
Medicare is looking for a way to create more seamless transitions from the hospital to home, skilled nursing care, or home health care. These transitions include helping te patients stay well enough that they don't have to return to the hospital.
For years, it has been said that most people who are readmitted into the hospital do not have to be - more often than not - they should be able to go home (or to a skilled nursing care facility), and with the proper care, they should be able to stay home and progress. The Centers of Medicare & Medicaid Services has collected a great deal of data that indicates that many hospital readmissions of Medicare patients are preventable and the agency announced a program in 14 communities aimed at eliminating these “unnecessary” hospital readmissions.
The Care Transitions Project has been created by CMS to improve health care processes so that patients, their caregivers, and their entire team of providers have what they need to keep patients from returning to the hospital for ongoing care needs, according to CMS.
There are several important components to keeping a individual from returning to the hospital. Two of the most important components are having excellent home care to help the patient stay healthy. Bcing up and coupling this type of care with regular follw-up visits with the doctor will ensure that the patient's health will improve.
The total cost of unplanned hospital readmissions exceeds $17 billion annually, and varies widely across states. One of five Medicare beneficiaries discharged from the hospital is readmitted within 30 days, and half of non-surgical patients are readmitted to the hospital without having seen an outpatient doctor in follow-up, according to a Commonwealth Fund-supported study in the New England Journal of Medicine.
By promoting seamless transitions from the hospital to home, skilled nursing care, or home health care, this community-wide approach seeks, not only to reduce hospital readmissions but to yield sustainable and replicable strategies that achieve high-value health care for Medicare beneficiaries
“Our data show that nearly one in five patients who leave the hospital today will be re-admitted within the next month, and that more than three-quarters of these re-admissions are potentially preventable,” said CMS Acting Administrator Charlene Frizzera.
“This situation can be changed by approaching health care quality from a community-wide perspective, and focusing on how all of the members of an area’s health care team can better work together in the best interests of their shared patient population.”
CMS will monitor the success of this project by watching the rates at which patients in these communities return to the hospital. Re-admission rates for hospitals have been tracked by CMS for some time, and will be available to consumers later this year through the Hospital Compare Web site at http://www.hospitalcompare.hhs.gov.
“The Care Transitions Project is a new approach for CMS,” added Barry M. Straube, M.D., chief medical officer for CMS and its Office of Clinical Standards & Quality director.
“Rather than focusing on one global problem and trying to apply a one-size-fits-all solution across the country, Care Transitions experts will look in their own backyards to learn why hospital re-admissions occur locally and how patients transition between health care settings. Based on this community-level knowledge, Care Transitions teams will design customized solutions that address the underlying local drivers of re-admissions.”
Communities in the following regions have been selected to participate in the project:
Providence, R.I.;
Upper Capitol Region, N.Y.;
Western Pennsylvania;
Southwestern New Jersey;
Metro Atlanta East, Ga.;
Miami, Fl;
Tuscaloosa, Ala.;
Evansville, Ind.;
Greater Lansing Area, Mich.;
Omaha, Neb.;
Baton Rouge, La.;
North West Denver, Colo.;
Harlingen, Texas; and
Whatcom County, Wash.
The work of the Care Transitions Project will respond to the unique needs of each of the 14 communities, says CMS.
Each of the CTP communities is led by a state Quality Improvement Organization (QIO). QIOs work throughout the country as part of CMS’s quality program to help health care providers, consumers and stakeholder groups to refine care delivery systems to make sure all Medicare beneficiaries get the high-quality, high-value health care they deserve.
Each QIO in the project is required to work with partners to implement the following:
a) Hospital and community system-wide interventions;
b) Interventions that target specific diseases or conditions; and
c) Interventions that target specific reasons for admission.
The following QIOs serve as Care Transitions leaders throughout the country:
Quality Partners of Rhode Island;
IPRO Inc. (in New York);
Quality Insights of Pennsylvania;
Healthcare Quality Strategies Inc. (in New Jersey);
Georgia Medical Care Foundation Inc.;
FMQAI (in Florida); AQAF (in Alabama);
Health Care Excel (in Indiana);
MPRO (in Michigan);
CIMRO of Nebraska;
Louisiana Health Care Review;
Colorado Foundation for Medical Care;
TMF Health Quality Institute (in Texas); and
Qualis Health (in Washington).
The Care Transitions Project will continue in all 14 communities through summer 2011. For more information about the Care Transitions Project, visit http://www.cfmc.org/caretransitions/. To learn more about the work that QIOs are doing across the country, visit http://www.cms.hhs.gov/qualityimprovementorgs.
How many times have you heard about someone coming home from the hospital after a successful operation, but they just didn’t get well. In fact, they got worse and worse until they ended up back in the hospital again. The doctors couldn’t figure out what happened until certain tests were performed and they found out that the person had an infection.
Usually, this was not just any infection. It was a severe infection, some sort of staph infection – and the biggest problem, besides the fact that these infections are extremely difficult to treat – is that it was caused by the hospital and/or the doctors that did the surgery.
Some of these infections end up in the blood stream; others affect various organs, others, such as urinary infections from catheters infect the bladder and kidneys.
It has been found that the majority of these infections can be prevented – often by doctors and the surgical team being more careful.
The issue of infections has become so prevalent that some hospitals are working on pilot programs that are trying to eliminate as many of them as possible. If the hospitals eliminate enough infections and other issues that bring people back into the hospital for another stay, they will receive bonuses from Medicare. In fact, Medicare is looking into programs that will give hospitals bonuses for better care of patients and pay them less if they have too many readmissions.
Infections can be extremely serious, or even fatal. For instance, a man in Missouri was in the hospital after a heart attack to have a pacemaker put in. Though the operation went very well, he became very ill after he returned home. The reason: a serious staph infection. The result: after 15 more surgeries and 84 days in the hospital, the man is still alive, but lost his right leg, part of his left foot, a kidney and his hearing. He just won a multi-million dollar lawsuit.
If you or someone you know has had surgery and is not getting well as projected, or is getting worse and there doesn’t seem to be an obvious reason, call your surgeon and your regular doctor. Have them test for infection right away. Insist on it. The sooner an infection is addressed, the better the chance it will heal.
Medicare will cover the cost of the hospitalization, and it might save someone else from the same situation because Medicare is beginning to look more carefully at the issue of infections – especially if a hospital has been involved in too many of them.
Most of us live our lives without too many emergencies to interrupt us. As a result, we have a tendency to get pretty comfortable and not be totally prepared in the event of certain emergencies – especially medical emergencies.
This can put us in a mess if we are suddenly faced with a medical situation where people – such as our doctors or hospital – need pertinent information from us to treat us. For example, we might break our leg, which in and of itself seems simple to deal with.
However, what if we are taking medicine for blood pressure, diabetes, heart issues or blood thinners? All of these medications can have an effect on how the doctors in the emergency room choose to treat us. They can also have a huge effect on our health.
If the doctors don’t know what medicines we are taking or how much, they could possibly give us conflicting medicine which could cause serious health issues.
There is an easy solution to this issue. Write it all down. A great suggestion is for you or a friend/family member to write down all your medications, the doses, and the times you take them. Include over-the-counter medicines, such as Tylenol or allergy medication. In addition, write down your blood type, religious preference, doctor’s name and phone number and an emergency name and phone number plus any allergies you might have. Put all of this information on one sheet of paper and fold it and put it in your wallet. In addition, give an extra copy to a friend or relative, as well as keeping one copy on a magnet on your refrigerator so it will be easy to find in an emergency.
Chances are that you won’t need to use this handy little paper, but in the event that it is necessary, it will keep your doctors informed and will keep you safe.
I recently ran across an article about what to do to prepare for a natural disaster. Since my mother used to work on disasters, such as hurricanes, floods and earthquakes, we were painfully aware of keeping water, blankets and a few other things in the car and a full emergency kit including canned goods, water, flashlights, battery operated radios and more in the house.
One of the things that the article said – and, yes, my mother says and does – is to have a medical emergency kit available at all times. We are not talking about a first aid kit. That goes with all the stuff in the car and in the house in case of a disaster or other kind of emergency, including medical.
The emergency medical kits we are talking about is a container or file that has insurance coverage information including your health insurance company policy number, Medicaid or Medicare policy numbers, a list of your medicine with prescription numbers and dosages, your doctors phone number, a copy of your medical history from your doctor (you can usually get a copy for free), and names and contact information for family or friends and your doctor. Just in case, you might want a change of clothes in an overnight bag, as well.
We all have a tendency to think in terms of other people having the emergencies and if we think of ourselves, we think it probably won’t happen. Even if we have diabetes or high blood pressure, or other conditions which could lead to serious complications, we don’t usually have things prepared in advance. Why is that? For one reason, who wants to think of having an attack of some sort and having to go into the hospital? None of us.
It is important, though, and could be life-saving, to have a kit, if not, your paperwork as discussed above. Often in a rush into the hospital, we are disoriented, even if we are not in the middle of something as serious as a heart attack, we are, after all, in the hospital and usually worried, frightened, stressed or all three.
So, help yourself and help the friends or family that will be there to take you to the hospital, as well as the doctors and nurses who will be treating you and trying to help you. If you haven’t prepared yet, take the time to do it right away. It could save your life.
Recently, we have written about comparisons between premiums for Medicare Supplement Policies, prescription drug policies and the coverage itself. In this piece we will address a study comparing hospitals and Medicare coverage.
The Centers for Medicaid and Medicare (CMS) has created an advertising campaign to the tune of $2 million to help people across the country compare hospitals – in their local area and nationwide.
The internet site is www.hospitalcompare.hhs.gov gives the average amount that Medicare has paid for specific health issues, such as a heart attack. For instance, in Dallas area hospitals, Medicare paid a Denton, TX hospital $10,461. By comparison, for the same treatment, Medicare paid an Irving, TX hospital $4,164.
Why the difference? There are many factors that contribute to the reasons that there are different payments to different medical centers and hospitals for various operations and procedures. A couple of factors that impact price and payments are whether a hospital is a teaching hospital, which incurs more expenses because of the teaching aspect, which can be costly. A second factor can be the financial implications if a hospital treats a high percentage of low-income patients. This becomes a factor because statistics show that often these hospitals are paid less because they depend on Medicare/Medicaid payments which are usually lower than insurance company payments or private payment.
In addition, because of being limited in coverage and finances, low income individuals and/or families often have poorer health.
One of the areas that the site comparing hospitals addresses, is the quality of care in hospitals. For instance, Baylor’s Heart and Vascular Hospital is listed as best at giving patients antibiotics one hour before surgery, following the proven information and statistics that show that doing so saves lives. The site also shows that Baylor has scored high customer satisfaction for is giving patients help and other items that they ask for – quickly – and not making them wait for a long time.
Other areas that the hospital compare program will address are the areas involving chronic lung illness and diabetes. In June, the site will begin reporting the numbers and percentages of deaths from pneumonia, which causes a substantial number of deaths in hospitalizations for many reasons.
There will be more comparisons of diseases and conditions added to the site based on how common the diseases or conditions are and the amount of information available.
If you find yourself in a situation where you may have to go into the hospital, or if you just want to be prepared in case the situation ever presents itself, log on to the hospital compare site at www.hospitalcompare.gov, and compare all the hospitals in your surrounding area. This will tell you how well patients are treated, how well they do after treatment, surgery or other procedures, and which hospitals are being paid how much for the procedure you might be needing. You have information available for free that can help you make one of the most important choices you may ever have to make.
