Medicare has started to fine hospitals that have readmissions within 30 days of discharge. There are many reasons for the readmissions which include medications; lack of education on certain chronic disease management; lack of resources and funding source. Given the cost issues and quality of care associated with readmissions, there is a need for quality discharge follow-up solutions. A landmark Burlington research study in 1974 found results of care provided by a physician and nurse practitioner to be comparable in regard to physical, emotional and social function, mortality, satisfaction, and quality of care (Lenz, E. R., Mundinger, M. O., Kane, R. L., Hopkins, S. C., & Lin, S. X., 2004). Based on the literature review examining the issue of having a nurse practitioner doing the home post discharge visits, it is shown to be comparable to the primary care physicians. The question is, can the visit reduce readmissions? Studies show that by reducing readmissions to the hospital or skilled nursing facility quality of life and functional abilities are better.
Background and Significance
Beginning in 2013, Medicare started fining hospitals the cost of the admission that has readmissions within thirty days of discharge for pneumonia, myocardial infarction and congestive heart failure. About one in twelve adults age twenty-one and older discharged from the community were readmitted within thirty days (Summers & Cunningham, 2013). Thirty day readmissions are much higher in those who have more complicated illness. Discharge planning, case management, discharge planners and disease management have not led to decrease in readmissions.
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...lly challenges us to be creative to be both cost effective in delivery of care and those patient outcomes remain acceptable. The ethics of social justice really comes into play.
Furthermore, social justice is a principle that nurse practitioners have adapted to by influencing policy for the welfare of the poor, sick, and vulnerable by maintaining human dignity. Social justice influences society by giving a voice to those who are suffering and creating new avenues to promote health and well-being. Nursing in general focuses on the common good through their practice in respect to human dignity, family, care of the poor. As well as serving the vulnerable; providing charity and justice; active stewardship of resources; and cultivating community adds to the importance of social justice in the home environment at discharge where many of these issues come into play.
home, decrease hospital readmission, and increase independence. “RPM uses wireless devices such as blood pressure monitors, glucometer adapters, tablet, EKG recorder, and pulse oximeter.” (Rockoff: 2015) Patients use these devices
Innovations in mobile technology have brought remote healthcare management to the forefront of advanced medical care. The ability to record the cardiac activity of a patient at home has been available for some time. But that method utilized a recording device worn by the patient, which needed to be brought in to a hospital or doctor’s office for a healthcare professional to analyze. Today, real-time monitoring in the patient’s home is a reality. Three of the telecommunication giants have stepped
pharmacists are not recognized as health care providers and consequently are limited in scope of practice, as well as compensation.1 However, this is not a universal or federal responsibility.1 With this being said pharmacists cannot be reimbursed by Medicare Part B under Section 1861 of the Social Security Act like many other healthcare providers.1
Introduction Healthcare in the United States is undergoing significant transition in part due to climbing healthcare cost and restructure of the healthcare system resulting from the enactment of the Affordable Care Act of 2010 (ACA). The objectives outlined in the ACA have led many organizations to a change in their delivery model. Clinical integration and integrated physician model as well as the development of Accountable Care Organizations and changes in hospital business models are but some of
and family depend on the nurse's decisions as nurses are the bridge between physician and patient. Without strong knowledge and training, the nurse will not be able to provide quality care which leads to an unsatisfactory outcome. “Of foremost importance is leadership to build toward a clarified vision for high-value home health care in the U.S. healthcare system”( Landers, Madigan, & Leff, 2016).
This helps with reducing 30-day readmission rates, and the overall health of the patient. The appointments are set up for the patient already so that they don’t forget to make them when they are home. The nurses and the case managers educate on the importance of follow-up care. This way the patient is not readmitted for the same disease again. At the same time the case manager is promoting health
The current state of affairs in the development of health policy in the United States is that it is constantly in flux and its implementation is disorganized and inefficient. As was the case with the recently passed Affordable Care Act legislation, political and lobbying interests often intersect in a manner that makes meaningful, most appropriate changes unlikely. The ACA kept in place the fractured nature of American health care and insurance, and appears to have benefited insurance companies
Contribution of primary care to health systems and health: Is it essential? Evidence of the health promoting power of primary care has increased ever since investigators have been able to differentiate primary care from other characteristics of the health services delivery system. Studies constantly show that primary care has a positive effect on health results. It reduces mortality and morbidity, and it is considerably more lucrative than specialty based care. Therefore primary care is essential
is may differ depending on whom is asking the question, as differing participates may have differing ideas about what quality means and why it is important. Being that quality is what unites patients and healthcare organizations, we can see the importance of quality and the need for strong policies and practices that improve patient care and their experience while receiving that care. Giannini (2015) states that this dualistic approach to quality utilizes separate measurements, conformance quality
In Tosha and Jo’s case, I would advise the couple to contact the VA hospital to see if they can assist them with medical treatment. I would also suggest filing any medical claims they have so they can begin receiving income for their disabilities, if any, sustained in the military. Referring the individuals to the Ryan White HIV/Aids program at the local Health Department, would be beneficial as well. The Ryan White program is geared toward individuals who do not have health care coverage and cannot
questions about any surgical procedure to the health care personnel before surgery can be performed. This paper will discuss, summarized and critique the brochure. (Red simple sentence) Summary: Preventing surgical errors brochure discussed the importance of patients to communicate any concerns, questions and problems they may have to the health care providers involved in their surgery such as the surgeon, nurses, nutritionist, physical therapists, social worker, and occupational therapist. A Patient’s
Introduction Discharge planning is the process by which follow up services are established to support the patient’s current and future medical needs after their release from an acute care hospital stay.1 The aim of discharge planning is to reduce and maintain costs, improve patient outcomes and ensure the patient receives the highest quality care. Discharge planning is a complex process, which includes the contribution of many health care workers.1 The planning process may include physical therapists
Nurse staffing ratio's in healthcare is an ongoing issue throughout the country. With healthcare being run like a business, the bottom line is sometimes thought to be more important than the safety of the patients. One will see through this paper by reviewing patient outcomes and mortality, nurse staffing ratios can affect the quality and safety of patient care. II. Literature Review The sources used were retrieved from the online Shapiro Library. Electronic databases, including CINAHL were used
(IOM) landmark report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs there has been growing awareness of the value of psychosocial support. A number of other professional and standard setting organizations have recognized the importance of and mandated social and emotional care as a part of their quality recommendations and/or measures, including Patient-Center Outcomes Research Institute (PCORI): 2012 Rese... ... middle of paper ... ...arguable savings to our healthcare system