After a review of the clinical information provided by Lenox Hill Hospital, the Medical Director has denied the admission to Lenox Hill Hospital. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. We have to deny this inpatient admission as the information was never submitted by the provider, is limited and/or incomplete for this requested service. We have requested information and it has not been submitted in a timely manner. This would include but not limited to your presenting symptoms, pertinent blood work results, imaging performed such as x-rays, vital signs upon presentation, physical examination and the course of treatment received in the
Lexington Medical Center is located in West Columbia, South Carolina. It is in the heart of the midlands here and is the hospital that everyone knows and loves. They have a 414 bed medical complex along with 60 medical practices, 6 community medical and urgent care centers, an occupational health center, Alzheimer’s care center and the largest extended care facility in the Carolinas. These facilities are served by over 600 physicians and 1,600 nurses within the hospital network.
Craig Hospital have significant mission, vision, and value that attract vast of citizens and allow them to succeed, achieving top ten rehab hospital in the nation. Nevertheless, Craig Hospital is in need for better strategy to support its decision logic of strategy formulation and strengthen the hospice markets as well as minimizing the risks of leveraging the resources they already possess. Diversification strategy is a great support strategy that assist the strategy formulation as it holds the key to controlling the hospital, market position, and long-term economic viability. There are two type of diversification; related diversification that focus on product and service, while unrelated diversification is more of creating a “portfolio” that
The patient presented with common signs of compartmental syndrome. The interventions suggested to the staff at the hospital were not fully completed. The interventions given during the case presentation consisted of assessing the six Ps, swelling, and vital signs. I took the vital signs of the patient and the nurse recorded them in their system. The patient’s blood pressure was not within normal limits, so the blood pressure completed manually. The manual blood pressure was still elevated. An increase in blood pressure can indicate pain, swelling, and impaired blood flow to the extremities. When I was with the nurse, she sent the patient for an x-ray. Furthermore, the nurse should have then assessed what the patient has been doing and done education with the patient to elevate the leg above his heart. Many people do not know the scientific rationale and positioning of elevating the extremity above the heart. The nurse should have also assessed the patients expectation of pain relief, since his current medication (Ibuprofen) was not working to his expectations. This is when we left the floor; therefore, I was not able to discuss the patient care with the nurse. The nurse simply asked the patient about some of the six Ps of compartmental syndrome and did not complete the assess...
Surgery is the most common treatment for all stages of colon cancer. Cancer cells may be removed by one of the below procedures:
After review of the clinical information provided by North Central Bronx Hospital, the Medical Director has denied your admission to North Central Bronx Hospital. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. You are a 56 year old female with complaints of worsening pressure-like chest pain on the left sided that radiated to your left arm and neck. The symptoms began when you were at rest and woke you from your sleep. Based on the Interqual guideline (a decision based program to determine medical need) criteria to for acute coronary syndrome the clinical guidelines were not met because troponins were negative, there was no diagnostic testing such as a stress test, or documentation of ischemia in the clinical information that was submitted.
Linda Medina was admitted to Kindred Hospital with a diagnosis of respiratory failure. She came to Kindred intubated and was on a ventilator because she was unable to breathe on her own. Initially, Mrs. Medina was not an appropriate candidate for physical, occupational, or speech therapy due to her respiratory status.
Upon arrival, she reported not taking her medication for nine months. She also refused the influenza and pneumonia vaccine however they were both administered despite patient refusal.
The major implication of this decision is that each state decides the type of evidence required to withhold or withdraw medical treatment from an incompetent patient. The state ...
There are several errors that can be observed in the case provided. The first is the absence of notes and test results from the referring clinic. The patient is not proficient in English, and a qualified Spanish interpreter was not utilized. The patient was then taken for an unnecessary x-ray, before being seen by a doctor, while his blood sugar was low. The student providing transport for the patient back to FAI was not aware of the patient’s situation.
Patient is an 88-year old white female. She was admitted to Friendship Village on 01/26/18. She is currently being treated for acute kidney injury (AKI), Coronary artery disease (CAD), and high blood pressure (HTN). The patient has a history of appendectomy, bunionectomy, hysterectomy, thyroidectomy. She was sent from Banner Desert Medical Center patient arrived by the EMS patient was unresponsive on the couch her husband found her, her husband attempted CPR. Patient mentioned having heart attacks in the past and injuring herself prior to coming to Friendship village that resulted in getting two pins put in her hips and having teeth knocked out of her mouth but this time when she had her recent heart attack she said was told her condition is
HOSPITAL COURSE: The patient was admitted. He was treated with IV steroids and antibiotics. He gradually improved. He is still having trouble with oxygenation however and, arrangements are being made for a higher flow oxygen at home. In addition he will use an oxymizer. Consideration was given to having him go to the ___ [PLACE] for physical therapy, but he has
Each day we are faced with making decisions regarding the plan of care and discharge of a patient based on the number of days an insurance company allows to treat the patient. Most times the days allowed are less than what is required to assist the patient back to their prior level of function and ability to safely return home. This causes an internal struggle for the provider and can lead to easily accepting what the insurance company allows even though it is not always best for the patient. Typically, we follow the rule of always doing what is right, which could mean that we keep the patient on the unit longer than the insurance will provide payment.
In reviewing this case study, it is the writer’s opinion that poor communication between doctors treating this patient, limited patient assessment, provider bias/judgment, and inferior diagnostic procedures contributed to this adverse event.
The provision states, “Respect for human dignity requires the recognition of specific patient rights, particularly, the right of self -determination. Self -determination, also known as autonomy, is the philosophical basis for informed consent in health care. Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgement; to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or penalty; and to be given necessary support throughout the decision-making and treatment process (nursingworld.org)”. Ms. Rogers cannot even get to this point because of the resident refusal to treat her. There could many things going on with her. She could have pancreatitis, gallbladder issues or many other diagnosis related to her abdominal pain. She won’t know until a physician does a full workup on her. She obviously wants to be seen or else she wouldn’t have come to the ER. She knows something is not right is she is staggering in the hospital. She has rights as a patient to be seen by a physician. I think is the resident doesn’t want to evaluate her then the ER nurse needs report that person and go find another physician to do the job. I would also talk to the house supervisor about the situation so it could be reported to administration. Doctors go into medicine to help all people, not to pick and choose who they want to
Disclosure of pertinent medical facts and alternative course of treatment should not be overlooked by the physician in the decision making process. This is very important information impacting whether that patient will go along with the recommended treatment. The right to informed consent did not become a judicial issue ...