My fifth week at CMC has created the opportunity for me to be a part of meetings that are important to the function of the hospital and making sure specific departments are working toward goals that will increase valuable relationships with the patients and the use of the resources the hospital has to offer. In the clinical resource management department it is important to review the resources and their functionality within the hospital to ensure the facility is not just investing money in useful resources but also making sure the people in the community are benefiting from them as well.
On Tuesday, I sat in on the URC, which is the utilization review committee meeting for the second time since I’ve started at CMC. The meeting was called to order by the head hospitalist, and then the first topic of discussion was to review the dashboard, which didn’t change much from the last meeting because only one month had passed. After the dashboard was read through we discussed the pneumonia readmission cases from the last meeting, and why there was so many of these particular cases. Along with the readmission cases there was a “LACE tool” created to score specific attributes into points which would then be converted into a percentage of expected and observed probability of death or
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After attending the meeting, I was assigned the task of creating a patient choice form that included all of the DME and infusion services in the area and out of the county so that the patients can easily look at their choices. Having these specific handouts are needed because some services are more conveniently located, or less expensive for specific services and they benefit from being able to choose from more than one
In conclusion, I found the lab session very informative and helpful in completing the Denison Hospital case assignment. It was particularly helpful in inputting the formula equations into the excel spreadsheet in order to answer the requirement questions of each section within the case study. Therefore, I look forward to future lab sessions on the assignments for Stratton Township Park and City of
notices to patients and their families, schedule and lead the meetings. Wishing to be actively involved in the process, I represented nursing along with the charge nurse of the unit and the charge aide.
...on rates have shown to improve when the facility is practicing patient- and family- centered care, which ultimately can increase the reimbursement rates from Medicare and Medicaid. The increase reimbursement rates are extremely important for non-profit health care system such as OhioHealth Mansfield whose revenue comes from over sixty percent in Medicare and Medicaid funding. The PFCC self-assessment tool was analyzed based on OhioHealth Mansfield with strengths and weaknesses, which one big weakness consisted in the personnel domain which consists of support for staff, and the utilization of patients and family involvement in decision making and new employees. The system change of adding the new role of the patient navigator allows collaboration with a diverse team including patient and family members, along with ultimately increasing patient satisfaction rates.
The purpose of this paper is to describe the role and functions of the Director of Health Information Management and the Supervisor of Medical Records Coder. I will provide a synopsis of what I observed and the activities I participated in during the learning experience. In addition I will provide an analysis of their primary roles and functions as they relate to nursing and patient services. Additionally, I will provide insights I have gained into the leadership behaviors or style as a result of my observations and interactions. Finally I will summarize my learning experience by comparing my observations to sources from the literature that present evidence, best practices, or standards related to this specific role.
There have been many factors that have led Coastal Medical Center to their current position, however, most of these problems stem from the former chief executive officer, Ron Henderson. During Mr. Henderson’s...
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.
Quality patient care is an ongoing endeavor that involves many different areas of healthcare. One area of healthcare that is often employed is Utilization Management. We read in John’s that UM “is composed of a set of processes used to determine the appropriateness of medical services provided during specific episodes of care” (John,2011). Things that are used to determine the appropriateness of care include the patient’s diagnosis, site of care, length of stay, and other clinical factors. This system consists of three main functions aimed at improving patient care and controlling healthcare costs. These functions include utilization review, case management, and discharge planning. One source states that it also includes the claim denials and appeals process (Interviewee C. Jarvis, e-mail communication, May 3, 2014). When used correctly, these UM processes can expedite the patient’s care and reimbursement. It also demonstrates to third party payers that the organization is taking measures to help control costs. This monitoring and management of patient healthcare needs ensur...
Patient care is the core of any hospital, without patients and hospital would be unable to operate. In this discussion board, I am going to describe patient experience model in my organization; including standards, measures, staff training, reward and recognition programs. Next I will discuss how well the customer service model works and provide 2 examples illustrating the effectiveness of the model. Following this I will describe the customer service model on my department, the role that nurses play, and how the nursing manager is involved. Finally, I will discuss how customer satisfaction is measured on your unit, and how it is maintained. Lastly I will describe why customer satisfaction is now tied to reimbursement.
There will also be fliers put up in every department. We also have a form you have to fill out then we verify it either you get it or you don’t, in return the patient has to get a measurement month at the end of it we ask you to do a survey. If the patient doesn’t meet our qualification you will not be allowed on the program next year.UK is working with us to really quantify this data to validate it for us to use it for grants. Everybody sent them to the lobby that’s the change Brandy is not going to be able to handle volume. If anybody has any free time that’s not scrubbing and wants to come and help over here on some Saturdays we will train you and we would love to have you. We have a 155 thousand dollars this year that helps a lot of people which is an increase about 40 thousand from last
It is obvious that there is a large gap between where Coastal Medical Center is and where they need and want to be. When comparing CMC’s competitors, Johnson Medical Center and Lutheran Medical Center, CMC needs to provide more efficient, high quality care and focus on more profitable priorities instead of funding multiple unsuccessful projects such as the fifty-three unfinished developments.
...ntinually evolve, a certain degree of freedom must be felt by its members, bureaucracy represents and organization from which chaos has completely been eliminated. Nurse Executives, therefore, will need to encourage staff to challenge existing practice. Given the current environment, creative conflict will need to be supported in order for our continued growth.” (McGuire, 1999, p. 9) I believe that Capital Health is on a path for success. They have modernized there organization chart causing a more decentralized environment. This new atmosphere fosters empowerment of its nursing staff. This sense of ownership over their practice provides growth not only for individual nurse, but the entire profession. This positive proactive change of the organizational structure will allow the hospital to experience continued growth and development that is propelled from within.
This is a nearly 40-minute interview. The object of this interview is the leader of a community medical centre. This medical centre has five physicians, two nutritionists, one occupational therapist, a nurse and three service desk receptionists. This medical centre serves the community of more than five thousand patients now. After the interview, integration of the following eight items in this leader’s characteristics and traits.
Due to WellStar being a multi facility health system, its organizational design is constantly being reviewed for simpler and more efficient processes. WellStar’s two smallest hospitals, WellStar Paulding and WellStar Douglas, previously under went reconstruction with regards to their hierarchical structure in Patient Access Services (PAS). WellStar Paulding, the smallest facility of the five hospitals, renovated their managerial chain of command in PAS. WellStar Paulding’s patient volume is less than half in comparison to the 4 additional hospitals. As a result, their staff is smaller and only requires minimal supervision. In the past WellStar Administrators requested supervisors for every department, a manager of the entire department, and a director that managed PAS’ management directly and PAS staff indirectly. Recent cuts ...
In U.S. news best hospitals 2014-15, John Hopkins Hospital is regionally ranked number 1 in Maryland and also the Baltimore Metro areas, in addition to being ranked nationally in 15 adult and 10 children specialties. (US News & World Report LP, n.d.). The hospital opened its doors in 1889, and has been ranked number 1, 22 of the 25-year history of the U.S. News and World Report (most recently in 2013) (John Hopkins Medicine, n.d., para 3). It’s mission is to “is to improve the health of our community and the world by setting the standard of excellence in patient care” and identifying 6 aims specifically to accomplish this (John Hopkins Medicine, n.d.b, para. 1). One glimpse of the strategic plan illustrates the comprehensive framework, by which
...d procedures are now being monitored to improve clinical processes. Ensuring that these processes are implemented in a timely, effective manner can also improve the quality of care given to patients. Management of the processes ensures accountability of the effectiveness of care, which, as mentioned earlier, improves outcomes. Lastly, providing reimbursements based on the quality of care and not the quantity also decreases the “wasting” and overuse of supplies. Providers previously felt the need to do more than necessary to meet a certain quota based on a quantity of supplies or other interventions used. Changing this goal can significantly decrease the cost of care due to using on the supplies necessary to provide effective, high-quality care. I look forward to this implementation of change and hope to see others encouraging an increase in high-quality healthcare.