Who Needs the Hospital?
|
|
|
- Cuthbert Adam Walsh
- 7 years ago
- Views:
Transcription
1 Who Needs the Hospital?
2 Hardwiring Clinical Pathways for Ambulatory Care Coordination Improves Quality, Efficiency, and Outcomes Barney Newman, MD Medical Director Arthur Forni, MD, MMM Associate Medical Director for Quality
3 WESTMED Medical Group Established 1996 by 16 physicians 225+ physicians caring for over 250,000 patients Over 30 specialties represented 4 polyclinics 90,000 sq. ft., 65,000 sq. ft., 100,000 sq. ft., and newest with 30,000 sq. ft. Lab and imaging services Advanced IT and shared EMR
4 Locations
5 Governance Structure Professional Corporation (PC) Wholly owned by physician shareholders Republican form of governance with elected shareholder Board of Directors Physicians in senior management roles No hospital or related ACO Partners
6 Multiple ACO-Based Contracts Empire Medicare Advantage Oxford Medicare Advantage Cigna Commercial Oxford Commercial Aetna Commercial Medicare Shared Savings Program 16,000 Medicare lives 30,000 Commercial lives
7 Value-Based Strategy Initial cost savings and quality improvement by focusing on reducing unnecessary expenses (low-hanging fruit) 1. Hospital care 2. ER and outpatient facilities 3. Specialty referrals and diagnostic testing 4. Pharmacy costs
8 Strategies for Paradigm Change Reduce unjustified variation Leverage EMR Leverage outpatient office infrastructure Make the right thing to do the easy thing to do Coordinate care
9 Care Coordination Care Coordination is the deliberate organization of patient care activities Main goals: 1. Transferring information 2. Transferring accountability
10
11 WESTMED Shared Savings: Initial Strategic Goals Reduce unnecessary hospitalizations Reduce unnecessary ER visits Reduce leakage to OON facilities Reduce leakage to OON specialties Reduce unnecessary imaging, procedures Reduce inappropriate end-of-life care WHILE DELIVERING HIGH QUALITY CARE
12 Phase I (approx. 6-9 mos) BUILDING INFRASTRUCTURE: First task was to assemble workgroups designed to implement the tactics, resources, educational efforts, etc. necessary for successful ACO quality and utilization oversight
13 Initial Workgroups 1. Case Management 2. Palliative Care 3. Urgent Care Management 4. Referral Management 5. Ambulatory Pathways
14 Workgroup Assignments Appoint Project Leader and define/assemble team Analysis to refine tactics/strategy Set initial target goals Develop project plan to achieve goals: tactics, needs, timeline, reports, etc.
15 Ambulatory Pathways Workgroup Team Art Forni, MD, MMM Maria Bradley, RN, MBA Anthony Korosi, MD Specialty Care Nephrologist Rupal Chhabra, DO Primary Care Internist James Cawley, PA UCC Deidre Morgan Project Coordinator
16 Ambulatory Pathways Workgroup Rationale Hospital care is expensive and potentially unsafe (med errors, infections, etc.) Subsets of patients not critically ill better served in outpatient settings if coordinated care orchestrated Multidisciplinary polyclinics facilitate such care, with ability to efficiently deliver wide range of services: UCC, outpatient IV suites, ambulatory endoscopy/surgery
17 Ambulatory Pathway Workgroup Goals Define outpatient sensitive conditions amenable to pathways Define specific pathway teams Develop pathways as per protocol to standardize and optimize how our clinicians treat patients with a variety of common conditions Provider education and availability of resources Reports to evaluate utilization, safety, and efficacy of pathways Refine pathways based on analysis of above metrics
18 Ambulatory Pathway Workgroup Goals Define outpatient sensitive conditions amenable to pathways Define specific pathway teams Develop pathways as per protocol to standardize and optimize how our clinicians treat patients with a variety of common conditions Provider education and availability of resources Reports to evaluate utilization, safety, and efficacy of pathways Refine pathways based on analysis of above metrics
19 Ambulatory Pathway Workgroup Goals Define outpatient sensitive conditions amenable to pathways Define specific pathway teams Develop pathways as per protocol to standardize and optimize how our clinicians treat patients with a variety of common conditions Provider education and availability of resources Reports to evaluate utilization, safety, and efficacy of pathways Refine pathways based on analysis of above metrics
20 Ambulatory Pathways PROGRESS TO DATE: 1. DVT 2. Acute Diverticulitis 3. Cellulitis 4. Diabetic foot ulcer 5. Community-acquired pneumonia 6. TIA 7. Upper GI bleed 8. Lower GI bleed
21 Ambulatory Pathways COMING SOON: 1. UTI/pyelo/prostatitis 2. CHF 3. Chest pain 4. Syncope 5. Asthma 6. COPD 7. Electrolyte abnormalities 8. Low back pain 9. Adverse drug reactions 10. Diabetes (hyperglycemia) 11. Palliative Care 12. Pain Management
22 Pathway Format Initial diagnostic evaluation Stratification (inpatient vs. outpatient) section Outpatient management Literature guideline reference that the pathway is based on Patient handout
23 Example: Cellulitis Outpatient Evaluation and Management of Cellulitis Patient with symptoms consistent with cellulitis CBC, CMET unless only mild infection. Also consider CPK, ESR, blood cultures if moderate/severe infection. Presence of any of the following: Hypotension, tachycardia, toxicity PE findings concerning for deep infection: violaceous bullae, pain out of proportion to exam, cutaneous hemorrhage, skin sloughing or anesthesia, gas in tissue, rapid progression Labs suggestive of systemic disease: CPK > 2-3x ULN, acidemia, acute renal insufficiency yes Hospitalize no
24 Cellulitis (cont.) no Presence of any of the following: Compromised host: ANC < 1000, HIV with CD4 < 200, currently on chemo, IDDM Presence of foreign body Involvement of intravascular device Presence of ulcer or bite wound yes Consider Hospitalization OR no Outpatient Management Discuss with ID to see if candidate for outpatient IV antibiotics: or Failed outpatient oral antibiotics but no severe criteria noted above to warrant hospitalization Clinical Infectious Diseases 2005; 41:
25 Cellulitis Outpatient Management 1. Antibiotic Therapy (7-10 days), consider one of the following: Dicloxacillin 500 mg PO QID Cephalexin 500 mg PO QID Augmentin 875/125 mg PO BID Clindamycin 300 mg PO Q6-8 hrs **If associated abscess or purulent drainage, consider one of the following for MRSA therapy: Clindamycin 300 mg PO Q6-8 hrs (not active against all MRSA strains) Trimethoprim/sulfamethoxazole DS 1 tab PO BID Doxycycline 100 mg PO BID Linezolid 600 mg PO BID **If associated animal bite wound, consider one of the following: Augmentin 875/125 mg PO BID Clindamycin 300 mg PO Q6-8 hrs + Ciprofloxacin 500 mg PO BID 2. Follow up in 2-3 days to monitor response to therapy. 3. Instruct patient to call for: Increasing pain, swelling, redness Fever, chills, lightheadedness Rash or itch Inability to tolerate oral antibiotics Nausea, vomiting, or diarrhea 4. Provide patient with handout.
26 Cellulitis Patient Information: Cellulitis What is Cellulitis? Cellulitis is an infection of the skin and soft tissue below the skin. It is usually caused by bacteria that normally live on the skin, such as staphylococci or streptococci. It usually develops when there is a break in the skin which allows bacteria to enter the skin and grow, causing redness and swelling. How is Cellulitis Treated? Most cases of cellulitis are mild and heal completely with antibiotic treatment. However, the infection can be complicated by abscesses needing drainage or can become severe and cause a systemic infection if left untreated. When Should I Call the Doctor? You should seek immediate medical attention for any of the following symptoms: Temperature greater than degrees F or chills Severe or worsening pain, swelling or redness of the area An inability to tolerate fluids or your antibiotics Severe rash or itch Nausea, vomiting, or diarrhea What Kind of Follow Up is Recommended? You should make a follow up appointment with your doctor around 2-3 days after your initial visit and diagnosis. Where Can I Get More Information? MedlinePlus
27 Ambulatory Pathway Workgroup Goals Define outpatient sensitive conditions amenable to pathways Define specific pathway teams Develop pathways as per protocol to standardize and optimize how our clinicians treat patients with a variety of common conditions Provider education and availability of resources Reports to evaluate utilization, safety, and efficacy of pathways Refine pathways based on analysis of above metrics
28 Small Group Meetings Preview the Pathways Solicit feedback, constructive criticism Encourage use of pathways highlight the ease of use and coordination of resources Communicate with team flag, , call Continue the experiment
29 Early Lessons Many providers unaware of resources available They do not know how to easily mobilize resources Clinical guidance not enough to accomplish our goals Need to make the pathways practical and accessible Make the right thing to do the easy thing to do
30 Integrating Pathways into the EMR
31 Integrating Pathways into the EMR
32 Integrating Pathways into the EMR
33 Integrating Pathways into the EMR
34 Integrating Pathways into the EMR
35 Integrating Pathways into the EMR
36 Integrating Pathways into the EMR
37 Integrating Pathways into the EMR
38 Care Coordination Transferring information Transferring accountability Primary care was initial focus Specialists (access, specialized testing) UCC becoming a major hub Outreach to our hospitalists and the ED physicians
39 Ongoing Process Refinement Ease of pathway use on day 1 Same day specialty consult and testing availability Primary provider access for f/u visits UCC hours/capabilities Patient education and buy-in Acute Case Management safety net
40 Ambulatory Pathway Workgroup Goals Define outpatient sensitive conditions amenable to pathways Define specific pathway teams Develop pathways as per protocol to standardize and optimize how our clinicians treat patients with a variety of common conditions Provider education and availability of resources Reports to evaluate utilization, safety, and efficacy of pathways Refine pathways based on analysis of above metrics
41 Phase II (Analyzing Metrics) Process measures overall pathway use by condition, acute case management use, % successful pathway completion Outcomes measures decreased ER visits and hospital admissions, successful observation status discharges
42 Phase II (Analyzing Metrics) All discharges MCR discharges 50 0 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12
43 Phase II (Analyzing Metrics) Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Total LOS MCR LOS d readmission % 0.0 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12
44 Phase II (Analyzing Metrics) 120 Weekly ER Visits ER Visits 20 0
45
46 Ambulatory Pathways SUMMARY: 1. Structured care coordination 2. Not just a keep patients out of the hospital approach 3. Limit unnecessary variation in clinical practice (especially overutilization) 4. Improve specialty access 5. Prevent errors 6. Provide a more comfortable experience for the patient 7. Decrease cost of care
47 Make the right thing to do the easy thing to do
Person Centered Care: Walk the Talk
Person Centered Care: Walk the Talk Integration of Nurse Practitioner (NP) Role into Extendicare Michener Hill Long Term Care (LTC) Presented by: Sandi Engi MN, NP Michener Hill Extendicare November 25
Establishing a Palliative Medicine Service in a Large Ambulatory Medical Group
Establishing a Palliative Medicine Service in a Large Ambulatory Medical Group Barney Newman, MD WESTMED Medical Director Maura L. Del Bene, APRN, PMHNP-BC, ANP, APHPCN Conflict of Interest Barney Newman,
UTILIZATION MANAGEMENT PROGRAM Introduction Health Care Services
UTILIZATION MANAGEMENT PROGRAM Introduction Health Care Services Call us: 1-888-898-7969, Option 1, then Option 4 Fax us: 1-800-594-7404 Business hours: Monday Friday (excluding holidays), 8:30 a.m. to
Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015
Leveraging the Continuum to Avoid Unnecessary Utilization While Improving Quality Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Karim A. Habibi, FHFMA, MPH, MS Senior
PROFESSIONAL BILLING COMPLIANCE TRAINING PROGRAM MODULE 5 OUTPATIENT OBSERVATION SERVICES
PROFESSIONAL BILLING COMPLIANCE TRAINING PROGRAM MODULE 5 OUTPATIENT OBSERVATION SERVICES Definition of Observation Care Medicare defines observation care* as: a well defined set of specific, clinically
POLICY AND PROCEDURE MANUAL
Policy Title: Authorization for Observation vs. Inpatient Admission for Contracted Hospitals Primary Department: Affiliated Department(s): N/A Last Revision Date: 09/12/2014 Revision Dates: 12/16/2011;
Analytic-Driven Quality Keys Success in Risk-Based Contracts. Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst
Analytic-Driven Quality Keys Success in Risk-Based Contracts March 2 nd, 2016 Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst Brian Rice, Vice President Network/ACO Integration,
Pressure Ulcers: Facility Assessment Checklists
Pressure Ulcers: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to managing pressure ulcers in the facility, in
Why Do Some Antibiotics Fail?
Why Do Some Antibiotics Fail? Patty W. Wright, M.D. April 2010 Objective To outline common reasons why antibiotic therapy is not successful and how this can be avoided. And to teach you a little bit about
Publication Year: 2013
IMPACT OF A CLINICAL DECISION SUPPORT TOOL IN THE EMERGENCY DEPARTMENT ON ANTIMICROBIAL PRESCRIBING PATTERNS FOR THE TREATMENT OF PNEUMONIA UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM Publication Year: 2013
POAC CLINICAL GUIDELINE
POAC CLINICAL GUIDELINE Acute Pylonephritis DIAGNOSIS COMPLICATED PYELONEPHRITIS EXCLUSION CRITERIA: Male Known or suspected renal impairment (egfr < 60) Abnormality of renal tract Known or suspected renal
SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D]
![SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D]](/thumbs/27/9667060.jpg "SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D]")
SUBSTANCE USE DISORDER SOCIAL DETOXIFICATION SERVICES [ASAM LEVEL III.2-D] I. Definitions: Detoxification is the process of interrupting the momentum of compulsive drug and/or alcohol use in an individual
OPEN DOOR FAMILY MEDICAL CENTERS, INC. POLICY AND PROCEDURE. Appointment Scheduling RESPONSIBLE DIRECTOR: Chief Operations Officer
OPEN DOOR FAMILY MEDICAL CENTERS, INC. POLICY AND PROCEDURE TOPIC: RESPONSIBLE DIRECTOR: AFFECTED DEPARTMENTS: AUTHORIZED BY: Appointment Scheduling Chief Operations Officer Patient Services, Nursing,
Streptococcal Infections
Streptococcal Infections Introduction Streptococcal, or strep, infections cause a variety of health problems. These infections can cause a mild skin infection or sore throat. But they can also cause severe,
Provider Manual. Section 18.0 - Case Management and Disease Management
Section 18.0 - Case Management and Disease Management 18.1.1 Introduction 18.2.1 Scope 18.3.1 Objectives 18.4.1 Procedures Case Management 18.4.1-A. Referrals 18.4.1-B. Case Management Mercy Maricopa Acute
Managing Patients with Multiple Chronic Conditions
Best Practices Managing Patients with Multiple Chronic Conditions Advocate Medical Group Case Study Organization Profile Advocate Medical Group is part of Advocate Health Care, a large, integrated, not-for-profit
May 9, 2013. FaithAnn Amond, RN Navigator Care Central Ellis Medicine
A Systems Approach to Diabetes Care Hospital to Home. Improving Care Transitions and Outcomes Helen Hayes Hospital West Haverstraw, NY James Desemone, MD Director of Medical Staff Quality Diabetes and
Managing Your Health Care Costs
Options for lower cost settings As a CareFirst BlueCross BlueShield or CareFirst BlueChoice, Inc. (CareFirst) member, how you use your benefits can reduce your health care costs. Use the information below
the Role of Patricia Turner BSN, RN, CWCN, CWS
Understanding the Role of Outpatient Wound Centers Patricia Turner BSN, RN, CWCN, CWS Outpatient wound centers are somewhat of a specialty unto themselves within the world of wound care. The focus of the
Kaiser Permanente: Transition Care Performance and Strategies
Kaiser Permanente: Transition Care Performance and Strategies Carol Ann Barnes, PT, DPT, GCS carbarne@gmail.com April 2009 Netta Conyers-Haynes, October, 2014 Principal Consultant, Communications Agenda
Electronic Medical Record Etiquette For Alec
Electronic Medical Record Etiquette For Alec ELECTRONIC MEDICAL RECORD DOCUMENTATION RESPONSIBILITY & USE POLICY A. INTRODUCTION 1. The Electronic Medical Record (EMR) at the Anne Arundel Health System(AAHS)
Low-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs
Low-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs MY BACKGROUND Practicing General Internal Medicine Physician Hospitalist at Newton-Wellesley Hospital Researcher at Brigham and Women s
PCMH and Care Management: Where do we start?
PCMH and Care Management: Where do we start? Patricia Bohs, RN, BSN Quality Assurance Manager Kelly McCloughan QA Data Manager Wayne Memorial Community Health Centers Honesdale, PA Wayne Memorial Community
Musculoskeletal Infection Care Process Model
Musculoskeletal Infection Care Process Model Musculoskeletal infections are serious and potentially life-threatening. Musculoskeletal infections include necrotizing fasciitis, septic arthritis, osteomyelitis,
What You Need to know about Your Pet s Upcoming Dentistry and Periodontal Treatment
What You Need to know about Your Pet s Upcoming Dentistry and Periodontal Treatment We are sending this packet of information in anticipation of your pet s upcoming dental procedure. Many people have questions
C-Difficile Infection Control and Prevention Strategies
C-Difficile Infection Control and Prevention Strategies Adrienne Mims, MD MPH VP, Chief Medical Officer Adrienne.Mims@AlliantQuality.org 1/18/2016 1 Disclosure This educational activity does not have commercial
New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery
New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery USING THE 48 HOUR OBSERVATION BED USING THE 48 HOUR OBSERVATION BED Detoxification
Our Patient-Centered Medical Home a Process, not a Click
Our Patient-Centered Medical Home a Process, not a Click Richard Johnston, M.D. President, Medical Clinic of North Texas, P.A. Medical Clinic of North Texas, P.A. MCNT Physician Owned Primary Care Medical
Expanding the team to the health care community. One practice s experience Holly Cleney, MD
Expanding the team to the health care community One practice s experience Holly Cleney, MD Objectives Develop a strategy for coordinating care effectively for patients across hospital stays and through
Connect4 Patients CCCM Primary Care Community. Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM
Connect4 Patients CCCM Primary Care Community Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM September 17, 2015 Objectives: Describe innovative care management
Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights
Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs Emily_Brower@AtriusHealth.org November 2013 1 Contents Overview of
SE5h, Sepsis Education.pdf. Surviving Sepsis
Surviving Sepsis 1 Scope and Impact of the Problem: Severe sepsis is a major healthcare problem that affects millions of people around the world each year with an extremely high mortality rate of 30 to
The Oregon Physical Therapy Association. presents. Medical Screening for the Physical Therapist. Home Study Course
The Oregon Physical Therapy Association presents Medical Screening for the Physical Therapist Home Study Course Medical Screening Full Course Medical Screening Refresher Course Instructors Richard Gicking,
Patient Optimization Improves Outcomes, Lowers Cost of Care >
Patient Optimization Improves Outcomes, Lowers Cost of Care > Consistent preoperative processes ensure better care for orthopedic patients The demand for primary total joint arthroplasty is projected to
Report a number that is zero filled and right justified. For example, 11 visits should be reported as 011.
OASIS ITEM (M2200) Therapy Need: In the home health plan of care for the Medicare payment episode for which this assessment will define a case mix group, what is the indicated need for therapy visits (total
Quality and Efficiency of Care Improved with Analytics and Workflow Redesign
Quality and Efficiency of Care Improved with Analytics and Workflow Redesign London Health and Care Leaders Forum June 2, 2015 Simeon Schwartz, MD CEO, WESTMED Medical Group, P.C. WESTMED Medical Group
Preoperative Laboratory and Diagnostic Studies
Preoperative Laboratory and Diagnostic Studies Preoperative Labratorey and Diagnostic Studies The concept of standardized testing in all presurgical patients regardless of age or medical condition is no
The Third National Medicare RAC Summit
The Third National Medicare RAC Summit Major Hospital Vulnerabilities II: Medical Necessity and Clinical Documentation Issues in Medicaid and RAC Audits Edmund L. Lafer, MD Temple University Health System
Certified Clinical Documentation Specialist Examination Content Outline - 2016
Certified Clinical Documentation Specialist Examination Content Outline - 2016 1. Healthcare Regulations, Reimbursement, and Documentation Requirements Related to the Inpatient Prospective Payment System
Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION
Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for
Utilization Management Program
Utilization Management Program The Utilization Management (UM) Program facilitates quality, cost-effective and medically appropriate services across a continuum of care that integrates a range of services
Improving Outcomes and Saving Lives in Real Time: How Hospitals Can Use Predictive Analytics Across the Care Continuum Essential Hospitals Engagement
Improving Outcomes and Saving Lives in Real Time: How Hospitals Can Use Predictive Analytics Across the Care Continuum Essential Hospitals Engagement Network February 18, 2015 CHAT FEATURE The chat tool
Intensive Rehabilitation Service & Community Treatment Team
Intensive Rehabilitation Service & Community Treatment Team Caroline O Donnell Integrated Care Director North East London Foundation Trust Carol White Deputy Integrated Care Director North East London
Medicare Patient Information. Patient Name: SS#: - - Date of Birth: / / Sex: Female Male. City: State: Zip Code:
Medicare Patient Information Patient Name: SS#: - - Date of Birth: / / Sex: Female Male Address: Street: City: State: Zip Code: Home Phone: ( ) - Work/Mobile Phone: ( ) - Please print your name as it Appears
Patient Electronic Alert to Key-worker System (PEAKS) Guidelines
Patient Electronic Alert to Key-worker System (PEAKS) Guidelines This procedural document supersedes: PAT/EC 4 v.1 Guidelines for Patient Electronic Alert to Key-worker systems (PEAKS). Did you print this
Maximizing Efficiency and Productivity in Your Rural ER. Bruce Penner, RN David D. Luehr, MD
Maximizing Efficiency and Productivity in Your Rural ER Bruce Penner, RN David D. Luehr, MD Can we afford to continue as we are? What if your ER had to pay for itself? What if you were rated on patient
National Clinical Programmes
National Clinical Programmes Section 3 Background information on the National Clinical Programmes Mission, Vision and Objectives July 2011 V0. 6_ 4 th July, 2011 1 National Clinical Programmes: Mission
Overcoming Barriers to Discharge for Home Infusion
VOLUME 19 CORAM S CONTINUING EDUCATION PROGRAM Overcoming Barriers to Discharge for Home Infusion Successful home infusion therapy relies on timely and effective transitions to home. Early identification
A case of concurrent deep venous thrombosis, pseudoaneurysm, and extremity abscess in an intravenous methamphetamine abuser
A case of concurrent deep venous thrombosis, pseudoaneurysm, and extremity abscess in an intravenous methamphetamine abuser BY MATTHEW L HARRISON Abstract Introduction. Intravenous drug abuse is a global
Lyme Disease in 2013: Lessons Learned in Diagnosis
Lyme Disease in 2013: Lessons Learned in Diagnosis John N. Aucott, M.D. Assistant Professor, Department of Medicine Johns Hopkins University School of Medicine Lyme Disease Research Foundation Park Medical,
After Your Gastrectomy
After Your Gastrectomy UHN Information for patients and families Read this information to learn: what a gastrectomy is how to care for yourself what problems to look out for who to call if you have any
Implementing the Long-Term Care UTI Toolkit Wisconsin Coalition on HealthCare Association Infection in Long Term Care
Implementing the Long-Term Care UTI Toolkit Wisconsin Coalition on HealthCare Association Infection in Long Term Care MetaStar Health Care Quality Symposium: The Value of Better Health Paula Kock RN paulak@parkmanorwi.com
Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy Gallbladder removal is one of the most commonly performed surgical procedures in the United States. Today,gallbladder surgery is performed laparoscopically. The medical name
RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home
RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home Sergio Petrillo, PharmD Clinical Pharmacist Specialist, Rhode Island Hospital
Dallas Neurosurgical and Spine Associates, P.A Patient Health History
Dallas Neurosurgical and Spine Associates, P.A Patient Health History DOB: Date: Reason for your visit (Chief complaint): Past Medical History Please check corresponding box if you have ever had any of
Managing Surgical Services Lines Under Accountable Care and Value-Based Purchasing. Becker s Healthcare Jeffry Peters February 28, 2013
Managing Surgical Services Lines Under Accountable Care and Value-Based Purchasing Becker s Healthcare Jeffry Peters February 28, 2013 Learning Objective How ACA/VBP changes how we measure surgical services
Cellulitis. Patient Information Leaflet. Contact numbers. Out of hours contact numbers
Contact numbers District Nurse: Intermediate Care Team: Your GP: Out of hours contact numbers District Nurse: Intermediate Care Team: Out of hours GP Service: If you would like this information in another
Jim Boswell, MBA VP Physician Services / BMHCC and CEO / BMG Robert Vest, JD COO / BMG
Jim Boswell, MBA VP Physician Services / BMHCC and CEO / BMG Robert Vest, JD COO / BMG ! Baptist Memorial Healthcare Corporation " Award Winning Network " 14 affiliate hospitals in Mid-South! Baptist Medical
High Desert Medical Group Connections for Life Program Description
High Desert Medical Group Connections for Life Program Description POLICY: High Desert Medical Group ("HDMG") promotes patient health and wellbeing by actively coordinating services for members with multiple
CMS Data What s In It & How To Use It. Kimberly Kauffman Executive Director Summit Health Solutions
CMS Data What s In It & How To Use It Kimberly Kauffman Executive Director Summit Health Solutions 2 Summit Health Solutions ACO w/ July 1, 2012 start date Wholly owned by Summit Medical Group Two hospital
How To Analyze Health Data
POPULATION HEALTH ANALYTICS ANALYTICALLY-DRIVEN INSIGHTS FOR POPULATION HEALTH LAURIE ROSE, PRINCIPAL CONSULTANT HEALTH CARE GLOBAL PRACTICE DISCUSSION TOPICS Population Health: What & Why Now? Population
Approved: Acute Stroke Ready Hospital Advanced Certification Program
Approved: Acute Stroke Ready Hospital Advanced Certification Program The Joint Commission recently developed a new Disease- Specific Care Advanced Certification program for Acute Stroke Ready Hospitals
Pneumonia Education and Discharge Instructions
Pneumonia Education and Discharge Instructions Pneumonia Education and Discharge Instructions Definition: Pneumonia is an infection of the lungs. Many different organisms can cause it, including bacteria,
Ann Hablitzel, RN, BSN, MBA Hospice Care of California
Ann Hablitzel, RN, BSN, MBA Hospice Care of California Objectives Describe the creations of new community based palliative care programs Identify criteria for admission Discuss philosophy and goals Analyze
Nurse Practitioners: their role in the QLD health workforce
Nurse Practitioners: their role in the QLD health workforce Sharyn Plath - Nurse Practitioner Redcliffe Hospital Emergency Department (RN, Midwife, BN/Hons, Grad Cert Intercultural Studies, Masters of
Using Root Cause Analysis to Determine Why Readmissions are High. Presentation Objectives. Background Information 11/30/2011
Using Root Cause Analysis to Determine Why Readmissions are High Nancy Seck RBN, BSN, MPH, CPHQ Director, Quality Management Glendale Memorial Hospital and Health Center Presentation Objectives Identify
3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients
Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential
MANAGEMENT OF COMMON SIDE EFFECTS of INH (Isoniazid), RIF (Rifampin), PZA (Pyrazinamide), and EMB (Ethambutol)
MANAGEMENT OF COMMON SIDE EFFECTS of INH (Isoniazid), RIF (Rifampin), PZA (Pyrazinamide), and EMB (Ethambutol) 1. Hepatotoxicity: In Active TB Disease a. Background: 1. Among the 4 standard anti-tb drugs,
Population Health Solutions for Employers MEDIA RESOURCES
Population Health Solutions for Employers MEDIA RESOURCES ABOUT MISSIONPOINT MissionPoint s mission is to make healthcare more affordable, accessible and improve the quality of care for our members. MissionPoint
Observation Coding and Billing
How do you get paid? Observation Coding and Billing Michael Ross MD FACEP President, Society of Chest Pain Centers Medical Director, Chest Pain Center and Observation Medicine Associate Professor, Department
Section 6. Medical Management Program
Section 6. Medical Management Program Introduction Molina Healthcare maintains a medical management program to ensure patient safety as well as detect and prevent fraud, waste and abuse in its programs.
A Plan For Better Health
A Plan For Better Health Welcome to Crystal Run Health Plans PPO Plans Your health and that of your family is most important. Your health plan should be designed for all your needs giving you access to
Emory Eye Center New Patient Questionnaire
Patient Name: Date: Current Address: Current Phone: Date of Birth: Primary Care Physician: Referring Physician: (First & Last Name) (First & Last Name) Pharmacy Name: Phone #: ( ) Please answer all questions
Limb Preservation Strategies: Quality Outcomes for the ACO Model. SPEAKERS: Audrey K Moyer-Harris MBA BSN RN CWCN Martha Kelso RN HBOT COO MWS LEAP
Limb Preservation Strategies: Quality Outcomes for the ACO Model SPEAKERS: Audrey K Moyer-Harris MBA BSN RN CWCN Martha Kelso RN HBOT COO MWS LEAP Disclosures Audrey K Moyer-Harris MBA BSN RN CWCN Executive
A Benefits Realization Management Strategy for EMR Implementation
A Benefits Realization Management Strategy for EMR Implementation E-Health Conference June 3, 2015 Toronto Convention Center Tammy DeGiovanni, Director Ambulatory Care Dr. Jim King, Physician and CMIO
Curriculum vitae. (Honors) 1999 M.B.B.S Medical School Al-Ameen Medical College, Bijapur, Karnataka, India.
Curriculum vitae Name: Office Address: Zubair A Syed, MD 5920 Forest Park Road. (6 th Floor) Dallas, Texas, 75390-9165 Work Phone: (214) 648-4128 Work E-Mail: Zubair.Syed@UTSouthwestern.edu Work Fax: 214-358-3708
CAUSES Pressure changes Respiratory infection-congestion or sinus infection
Page 1 of 6 pages NOTE Contact Surgeon before giving any medication marked with an asterisk. In an emergency or during Loss of Signal, begin appropriate treatment; then call Surgeon as soon as possible.
75-09.1-08-02. Program criteria. A social detoxi cation program must provide:
CHAPTER 75-09.1-08 SOCIAL DETOXIFICATION ASAM LEVEL III.2-D Section 75-09.1-08-01 De nitions 75-09.1-08-02 Program Criteria 75-09.1-08-03 Provider Criteria 75-09.1-08-04 Admission and Continued Stay Criteria
Medical Decision Making. Michael Nauss MD FACEP Senior Staff HFH Dept. of Emergency Medicine
Medical Decision Making Michael Nauss MD FACEP Senior Staff HFH Dept. of Emergency Medicine Billing 101: Down coding Compared to national benchmark: HFH -1% on critical care When compared to Level 5 billing:
How To Help A Nursing Home And Hospital Collaborate
Continuum of Care Bridging the Gap between the Hospital and Nursing Home Scott Wells, RN MSN Tiffany Noller, RN MSN Objectives Name key members involved in hospital/nursing home collaborative Identify
Date: Referring Facility: Phone#: Anticipated Patient Needs (Please check appropriate boxes and include details within referral paperwork)
Barbara McInnis House Initial Referral Form Please fill form out completely. Include additional forms if prompted. Fax to Admissions Department. Follow up with a phone call. Patient Name: DOB: Gender:
Performance Dashboard Appendix 1 Trust Board - 19th June 2012
Performance Dashboard Appendix 1 Trust Board - 19th June 2012 Code Integrated Performance Measure Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Criteria for Traffic
Population Health Management: Banner Health Network s Perspective. Neta Faynboym, Medical Director Banner Health Network
Population Health Management: Banner Health Network s Perspective Neta Faynboym, Medical Director Banner Health Network 29 Acute Care Hospitals BANNER AT A GLANCE Banner Health Network with 400K lives
Antibiotic Guidelines: Ear Nose and Throat (ENT) Infections. Contents
Antibiotic Guidelines: Ear Nose and Throat (ENT) Infections. Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine
Supplemental Technical Information
An Introductory Analysis of Potentially Preventable Health Care Events in Minnesota Overview Supplemental Technical Information This document provides additional technical information on the 3M Health
Disease Modifying Therapies for MS
Disease Modifying Therapies for MS The term disease-modifying therapy means a drug that can modify or change the course of a disease. In other words a DMT should be able to reduce the number of attacks
Employee Population Health Management:
Employee Population Health Management: a stepping stone for accountable care Richard Boehler, MD, MBA, FACPE President and Chief Executive Officer St. Joseph Hospital, Nashua N.H. Learning to Manage Populations
Health Care Leader Action Guide to Reduce Avoidable Readmissions
Health Care Leader Action Guide to Reduce Avoidable Readmissions January 2010 TRANSFORMING HEALTH CARE THROUGH RESEARCH AND EDUCATION Osei-Anto A, Joshi M, Audet AM, Berman A, Jencks S. Health Care Leader
It s Time to Transition to ICD-10
July 22, 2015 It s Time to Transition to ICD-10 What do the changes mean to your SNF? Presented by: Linda S. Little, RN-BSN Clinical Consultant HMM Consulting Office: (631) 265-6289 E-Mail: llittle@horanmm.com
It Takes Two to ACO A Unique Management Partnership
AMGA 2014 Annual Conference, April 4, 2014 It Takes Two to ACO A Unique Management Partnership Scott Hayworth MD, President & CEO Mount Kisco Medical Group Alan Bernstein MD, Senior Medical Director Mount
Illinois Department of Public Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION. Statement of LICENSURE Violations
(X1) PROVER/SUPPLIER/CLIA ENTIFICATION NUMBER: (X3) SURVEY D NAME OF PROVER OR SUPPLIER (X4) SUMMARY REGULATORY OR LSC ENTIFYING INFORMATION) PROVER'S PLAN OF CORRECTION Final Observations Statement of
Physician and other health professional services
O n l i n e A p p e n d i x e s 4 Physician and other health professional services 4-A O n l i n e A p p e n d i x Access to physician and other health professional services 4 a1 Access to physician care
Transition Post Hospital Discharge
Transition Post Hospital Discharge Transition Post Hospital Discharge Independent Clinic Experience Privately owned Who is Multicare Primary Care Focused Fridley, Blaine, Roseville 13 FP, 3 Peds, 4 OB,
Prevention and Recognition of Obstetric Fistula Training Package. Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula
Prevention and Recognition of Obstetric Fistula Training Package Module 8: Pre-repair Care and Referral for Women with Obstetric Fistula Early detection and treatment If a woman has recently survived a
Case Studies Patient Centered Medical Home
Case Studies Patient Centered Medical Home A 360 Degree View of the Medical Home in Action Presented by: Jackie Hayes, RN Executive Director of Clinical Services WellStar Healthcare Systems Lora Baker
Urinary Diversion: Ileovesicostomy/Ileal Loop/Colon Loop
Urinary Diversion: Ileovesicostomy/Ileal Loop/Colon Loop Why do I need this surgery? A urinary diversion is a surgical procedure that is performed to allow urine to safely pass from the kidneys into a
Realizing ACO Success with ICW Solutions
Realizing ACO Success with ICW Solutions A Pathway to Collaborative Care Coordination and Care Management Decrease Healthcare Costs Improve Population Health Enhance Care for the Individual connect. manage.
The New Complex Patient. of Diabetes Clinical Programming
The New Complex Patient as Seen Through the Lens of Diabetes Clinical Programming 1 Valerie Garrett, M.D. Medical Director, Diabetes Center at Mission Health System Nov 6, 2014 Diabetes Health Burden High
Nurse Aide Training Program Application Checklist
Nurse Aide Training Program Application Checklist The following checklist must be completed before enrolling in the Nurse Aide Training course: Complete, sign, and date the Application Form Have the physical
Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System
Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System 1 Explain how patients experience transitions of care Identify variables that affect transitions due to lack of patient