Evaluating the Effectiveness of Communityand Hospital MedicaBetseyCalderon89
Evaluating the Effectiveness of Community
and Hospital Medical Record Integration
on Management of Behavioral Health
in the Emergency Department
Stephanie Ngo, MD
Mohammad Shahsahebi, MD, MBA
Sean Schreiber, MSED, LPC
Fred Johnson, MBA
Mina Silberberg, PhD
Abstract
This study evaluated the correlation of an emergency department embedded care coordinator
with access to community and medical records in decreasing hospital and emergency
department use in patients with behavioral health issues. This retrospective cohort study
presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking
at all-cause healthcare utilization, care coordination was associated with a significant median
decrease of one emergency department visit per patient (p G 0.001) and a decrease of 9.5 h in
emergency department length of stay per average visit per patient (pG0.001). There was no
significant effect on the number of hospitalizations or hospital length of stay. This intervention
demonstrated a correlation with reducing emergency department use in patients with behavioral
health issues, but no correlation with reducing hospital utilization. This under-researched
approach of integrating medical records at point-of-care could serve as a model for better
emergency department management of behavioral health patients.
Address correspondence to Mohammad Shahsahebi, MD, MBA, Department of Community and Family Medicine, Duke
University, Durham, NC, USA. Phone: (919) 342-8845; Email: [email protected]
Stephanie Ngo, MD, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Fred Johnson, MBA, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Mina Silberberg, PhD, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Mohammad Shahsahebi, MD, MBA, Northern Piedmont Community Care, Durham, NC, USA. Phone: (919) 342-8845;
Email: [email protected]
Fred Johnson, MBA, Northern Piedmont Community Care, Durham, NC, USA.
Sean Schreiber, MSED, LPC, Alliance Behavioral Health, Raleigh, NC, USA.
Journal of Behavioral Health Services & Research, 2017. 651–658. c)2017 National Council for Behavioral Health. DOI
10.1007/s11414-017-9574-7
Evaluating the effectiveness of community NGO ET AL. 651
Introduction
Background
Patients with behavioral health issues often require more resource-intensive care and are more
likely to be frequent users of health services.1–7 Brennan et al. found that patients with at least one
primary psychiatric visit to the emergency department (ED) were 4.6 times more likely than those
without a primary psychiatric visit to be classified as high utilizers of health services overall, and
that on average, high utilizers with a primary psychiatric visit had a significantly higher number of
ED visits than non-psychiatric high utilizers.7
Furthermore, Bboarding^ of patients with behavioral health issues has become a serious problem
for patients who requi ...
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
Unit 1Emergency Department Overcrowding Due to L.docxwillcoxjanay
Unit 1
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Teresa Cochran
November 12, 2015
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Emergency Department overcrowding related to patients seeking care for non-emergent conditions is an increasing concern for hospitals across the country. In rural areas, this issue is of concern not only for patient care but also has an impact economically on hospital financial viability.
Current Situation
Emergency Departments are designed to provide expedient care for individuals with emergent, life-threatening situations. However, in the current state, emergency departments are increasingly serving as a source of providing primary care. The resulting inappropriate use of the emergency department for non-emergent visits has been shown to increases cost, impact patient safety and quality.
Healthcare organizations must find and development innovative methods to provide quality patient care while maintaining low cost and maximum efficiencies. While demand for Emergency Services grows in part due to an aging population, the volume also has grown due to lack of primary care physicians and patient preference. The financial pressures faced by hospitals due to reductions in reimbursement necessitate a restructuring of the standard model of healthcare care delivery.
Problem Statement
As the population continues to grow emergency departments will continue to see not only acute illness but more chronic illness. It is essential for health care systems to continue in developing new and innovative means related to optimization of care delivery. Specifically this will identify factors that affect overutilization of the emergency department by individuals that are more appropriately treated in the primary care setting. Therefore, the increasing use of emergency departments will impact overall patient care due to lack of continuity that is provided in the primary care setting for chronic illness.
Research Objective
This research proposal will evaluate the feasibility of incorporating a medical home into the emergency department setting, therefore, reducing overcrowding in the Emergency Department. This increased access to primary care will ultimately increase access to quality care in the most appropriate cost-effective setting
Research Question
The intended purpose of this research proposal will examine the concept volume and acuity of patients seen in the Emergency Department. The following questions will be addressed. What measures can be implemented to reduce the overutilization of the ED yet offer the appropriate level of care for the patient? What barriers are associated with accessing sustained primary care?
Hypothesis
In order to improve outcomes, healthcare organizations must evaluate the feasibility of healthcare redesign related to the delivery of care. By restructuring how and where care is delivered will reduce the number of non-eme ...
Evaluating the Effectiveness of Communityand Hospital MedicaBetseyCalderon89
Evaluating the Effectiveness of Community
and Hospital Medical Record Integration
on Management of Behavioral Health
in the Emergency Department
Stephanie Ngo, MD
Mohammad Shahsahebi, MD, MBA
Sean Schreiber, MSED, LPC
Fred Johnson, MBA
Mina Silberberg, PhD
Abstract
This study evaluated the correlation of an emergency department embedded care coordinator
with access to community and medical records in decreasing hospital and emergency
department use in patients with behavioral health issues. This retrospective cohort study
presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking
at all-cause healthcare utilization, care coordination was associated with a significant median
decrease of one emergency department visit per patient (p G 0.001) and a decrease of 9.5 h in
emergency department length of stay per average visit per patient (pG0.001). There was no
significant effect on the number of hospitalizations or hospital length of stay. This intervention
demonstrated a correlation with reducing emergency department use in patients with behavioral
health issues, but no correlation with reducing hospital utilization. This under-researched
approach of integrating medical records at point-of-care could serve as a model for better
emergency department management of behavioral health patients.
Address correspondence to Mohammad Shahsahebi, MD, MBA, Department of Community and Family Medicine, Duke
University, Durham, NC, USA. Phone: (919) 342-8845; Email: [email protected]
Stephanie Ngo, MD, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Fred Johnson, MBA, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Mina Silberberg, PhD, Department of Community and Family Medicine, Duke University, Durham, NC, USA.
Mohammad Shahsahebi, MD, MBA, Northern Piedmont Community Care, Durham, NC, USA. Phone: (919) 342-8845;
Email: [email protected]
Fred Johnson, MBA, Northern Piedmont Community Care, Durham, NC, USA.
Sean Schreiber, MSED, LPC, Alliance Behavioral Health, Raleigh, NC, USA.
Journal of Behavioral Health Services & Research, 2017. 651–658. c)2017 National Council for Behavioral Health. DOI
10.1007/s11414-017-9574-7
Evaluating the effectiveness of community NGO ET AL. 651
Introduction
Background
Patients with behavioral health issues often require more resource-intensive care and are more
likely to be frequent users of health services.1–7 Brennan et al. found that patients with at least one
primary psychiatric visit to the emergency department (ED) were 4.6 times more likely than those
without a primary psychiatric visit to be classified as high utilizers of health services overall, and
that on average, high utilizers with a primary psychiatric visit had a significantly higher number of
ED visits than non-psychiatric high utilizers.7
Furthermore, Bboarding^ of patients with behavioral health issues has become a serious problem
for patients who requi ...
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, AND PROJECT INSTRUCTIONS
Page | 1
Quality
Nearly fifteen years ago, the Institute of Medicine published the “To Err Is Human” report, which exposed the substantial impact of medical errors in the US healthcare system and called for a dramatic system change, including an improved understanding of those errors (McCarthy, Tuiskula, Driscoll, & Davis, 2017). Medical errors are considered to be failure to achieve the original goal or plan of action, and these errors may range from a patient falls to a mistake in the operating room. Not only do medical errors cause harm to the patient and jeopardize the patient’s trust, but they also cause a financial strain for the health system (“To Err is Human,” 1999). One of the contributing factors to medical errors is the lack of effective communication between doctors who are treating the same patient. This results in healthcare providers overprescribing medications for patients as well as increases the possibility of a patient having unnecessary tests or procedures performed. The report’s four-tiered approach includes:
· Focusing on creating a stronger foundation of education on patient safety
· Mandating a nationwide reporting system to encourage timely reporting of errors
· Increasing the standards of performance for healthcare providers
· Taking advantage of the security that safety systems offer (“To Err is Human,” 1999)
Creating a strong educational foundation for patient safety is most important. Healthcare personnel are much more likely to actively participate in reporting systems, encourage one another to perform at a higher level, and take advantage of safety systems when they are well educated on patient safety and the implications of medical errors. The reporting system seems to provide the least amount of impact on patient safety as they can result in losing patient trust in certain healthcare systems. The healthcare system as a whole has made progress in establishing a safe environment for patients when they are in need of care.
Challenges for Patient Safety and Steps for Improvement
Despite continuing evidence of problems in patient safety and gaps between the care that patients receive and the evidence about what they should receive, efforts to improve quality in healthcare show mostly inconsistent and patchy results.
Tap each image to know more.
Data Collection and Monitoring Systems
This always takes much more time and energy than anyone anticipates. It is worth investing heavily in data from the outset. Assess local systems, train people, and have quality assurance.
Tribalism and Lack of Staff Engagement
Overcoming a perceived lack of ownership and professional or disciplinary boundaries can be very difficult. Clarify who owns the problem and solution, agree roles and responsibilities at the outset, work to common goals, and use shared language.
Convince People That There's a Problem
Use hard data to secure emotional e ...
Unit 1Emergency Department Overcrowding Due to L.docxwillcoxjanay
Unit 1
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Teresa Cochran
November 12, 2015
Emergency Department Overcrowding Due to Lack of Access to Primary Care
Emergency Department overcrowding related to patients seeking care for non-emergent conditions is an increasing concern for hospitals across the country. In rural areas, this issue is of concern not only for patient care but also has an impact economically on hospital financial viability.
Current Situation
Emergency Departments are designed to provide expedient care for individuals with emergent, life-threatening situations. However, in the current state, emergency departments are increasingly serving as a source of providing primary care. The resulting inappropriate use of the emergency department for non-emergent visits has been shown to increases cost, impact patient safety and quality.
Healthcare organizations must find and development innovative methods to provide quality patient care while maintaining low cost and maximum efficiencies. While demand for Emergency Services grows in part due to an aging population, the volume also has grown due to lack of primary care physicians and patient preference. The financial pressures faced by hospitals due to reductions in reimbursement necessitate a restructuring of the standard model of healthcare care delivery.
Problem Statement
As the population continues to grow emergency departments will continue to see not only acute illness but more chronic illness. It is essential for health care systems to continue in developing new and innovative means related to optimization of care delivery. Specifically this will identify factors that affect overutilization of the emergency department by individuals that are more appropriately treated in the primary care setting. Therefore, the increasing use of emergency departments will impact overall patient care due to lack of continuity that is provided in the primary care setting for chronic illness.
Research Objective
This research proposal will evaluate the feasibility of incorporating a medical home into the emergency department setting, therefore, reducing overcrowding in the Emergency Department. This increased access to primary care will ultimately increase access to quality care in the most appropriate cost-effective setting
Research Question
The intended purpose of this research proposal will examine the concept volume and acuity of patients seen in the Emergency Department. The following questions will be addressed. What measures can be implemented to reduce the overutilization of the ED yet offer the appropriate level of care for the patient? What barriers are associated with accessing sustained primary care?
Hypothesis
In order to improve outcomes, healthcare organizations must evaluate the feasibility of healthcare redesign related to the delivery of care. By restructuring how and where care is delivered will reduce the number of non-eme ...
A look at strategies for lowering hospital readmissions across the continuum of care.
Hospital readmissions are a multi-dimensional problem. No single player or entity is entirely responsible for reducing excess readmissions. By improving our understanding of each touch point along the patient care continuum, strategies can be developed that ultimately reduce total readmissions.
This paper explores the roles of patients and providers in reducing readmissions and reviews several strategies that each can implement to help reduce readmission rates.
-Which patients are at high risk of hospital readmission?
-Comprehensive discharge planning strategies
-The physician’s role in lowering hospital readmission rates
-Optimizing communications handoffs between providers
-Building patient-centered transitional care models
-End of life planning
Improving Discharge Procedures to Reduce Unnecessary Emergency DMalikPinckney86
Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits
Name:
DNP Project Proposal
Purdue University Global
1
Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states.
Unnecessary return visits are indicators of poor care quality.
Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000).
This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge.
The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups.
Purdue University Global | This is Where the Title of the Presentation Will Go
2
Introduction
Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states. Unnecessary return visits are indicators of poor care quality. Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000). This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge. The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups. Providing verbal and pre-formatted written discharge instructions to the patient does not guarantee that the patient understands information provided. The patient must understand the medical information given and participates in their care. The best way to achieve patient understanding is communicating, and reinforcing while acknowledging culture, belief and language barriers.
2
Project Purpose
The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding.
The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet.
The patient and the provider will document the exchange by both signing the discharge tool. The tool will remain in the patient’s medical records.
Cite your slides here
3
Introduction
The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding. The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet. The patient and the provider will document the exchange by both signing the discharge tool. The ...
BENCHMARK 1
Evidence-Based Practice Project: PICOT Paper
Daysha Y. Polk
NUR 550
Grand Canyon University
June 1st, 2021
Evidence-Based Practice Project: PICOT Paper
Generally, a high level of patient satisfaction for the clients in the emergency department (ED) is vital, especially at this time when the healthcare system is shifting towards patient-centered care. Prakash (2010) notes that patient satisfaction levels significantly impact on medical malpractice claims, patient retention, and clinical outcomes. That is, it affects quality healthcare’s timely, efficient, and patient-centered delivery, making it both a proxy but a very effective key indicator for measuring the hospitals and doctors’ success. Consequently, supporting the improvements of patient satisfaction levels can positively affect several healthcare organizations’ components, such as preventive possible malpractice lawsuits, securing a positive local reputation, and enhancing patient retention rates. Thus, there is an increased need to develop strategies to improve ED patient’s satisfaction with the provided care services. Increasingly, the use of real-time location systems (RTLS) by hospitals to track patients, instead of relying on the traditional, manually-entered status updates, is increasingly being viewed as a better strategy to decrease the number or rate of Left Without Being Treated (LWBT) patients, and thus, improve ED patient’s satisfaction levels and hospital’s revenue collection (Boulos & Berry, 2012). Thus, the paper will explore whether the utilization of RTLS in the hospital’s ED, compared to manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services.
A wide array of factors is responsible for the decreased rate of satisfaction levels amongst ED patients. The current delays, long waits, leaving without being treated, decreased revenue collection from the ED unit, and reduced patient satisfaction scores have negatively portrayed the hospital's reputation to the public. As a result, the daily patient visits have continued to decrease as people attribute the facility to poor emergency care services delivery. All these complications result from the use of combined data resources and manual entry status updates when tracking patient records. This manual tracking cannot meet the demand for many patients and leads to overcrowding due to and reduced patient flow in the ED. Therefore, there is a need to install an automatic patient tracking system to increase the flow.
Patient satisfaction level, especially for hospital’s emergency department (ED) is increasingly becoming a key health quality indicator. Patient satisfaction regards the degree to which patients are happy with their healthcare (Heath, 2016). Patient satisfaction levels is a care quality measure and gives healthcare providers infor ...
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996). For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000). Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013). The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019). The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996).
For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000).
Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013).
The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019).
The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
PAGE
Walden University
February 2018
Abstract
The practice problem identified is headache sufferers are not adequately getting their headaches controlled. They are utilizing the emergency room for pain control which only gives them immediate control but not long-term control. The emergency rooms are becoming overcrowded. Controlling headache patients pain will help keep them out of the emergency room and help to decrease the overcrowding of the emergency rooms. Controlling the headache pains will also help decrease costs to consumers and the healthcare system. Case managers can help not only educate these patients, but they can increase better continuity of care and be able to provide feedback to the physicians. The better educated these patients are, the less likely they are to go to the emergency room. The practice problem question to be answered is to examine if an education plan along with a plan of care with primary care provider and network, will assist in increasing headache control and ultimately keep these patients out of the emergency rooms. The purpose of this project will be to implement an education protocol for headache patients to evaluate usage of the emergency department for headache pain control. Models that will be useful for this project are Pender’s Health Promotion Model and the Health Belief Model. These models will help to evaluate individuals and how they interact and behave in order to be able to change their behavior and help them to control their headache pain. This protocol can be included for provider’s and case managers within a clinically integrated network so that a greater number of patients can be managed effectively to decrease emergency room visits. The expected results will be this educational protocol will help patients control their headaches better and will assist in decreasing emergency room visits. The implications of this project will include increased control on headaches, decrease emergency room visits from headaches, and better quality of life for headache patients.
Utilizing Nursing Education and Intervention as a Method to Decrease Emergency Department (ED) Visits for Headache
by
Jodi Raisor
.
Table of Contents
Section 1: Nature of the Problem …………………………………………………………3
3
Introduction
3
Background
4
Problem Statement
6
Purpose Statement
6
Project Question
7
Framework for the Project
7
Implications for Social Change
8
Definition of Terms
9
Assumptions
9
Scope and Delimitations
10
Limitations
10
Significance
10
Summary
12
Section 2: Background and Context
12
Introduction
12
Literature Search Strategy
13
Concepts, Models and Theories
15
Systematic Literature Review Related to Methods
15
Role of the DNP Student
15
Role of the Project Team
16
Summary
17
Section 3: Methodology
17
Introduction
17
Project Design and Methods
18
Exclusion Criteria
18
Inclusion Criteria
18
Data Analysis
19
Protection of Human Rights
19
Summary
21
References
Section 1:.
A look at strategies for lowering hospital readmissions across the continuum of care.
Hospital readmissions are a multi-dimensional problem. No single player or entity is entirely responsible for reducing excess readmissions. By improving our understanding of each touch point along the patient care continuum, strategies can be developed that ultimately reduce total readmissions.
This paper explores the roles of patients and providers in reducing readmissions and reviews several strategies that each can implement to help reduce readmission rates.
-Which patients are at high risk of hospital readmission?
-Comprehensive discharge planning strategies
-The physician’s role in lowering hospital readmission rates
-Optimizing communications handoffs between providers
-Building patient-centered transitional care models
-End of life planning
Improving Discharge Procedures to Reduce Unnecessary Emergency DMalikPinckney86
Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits
Name:
DNP Project Proposal
Purdue University Global
1
Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states.
Unnecessary return visits are indicators of poor care quality.
Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000).
This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge.
The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups.
Purdue University Global | This is Where the Title of the Presentation Will Go
2
Introduction
Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states. Unnecessary return visits are indicators of poor care quality. Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000). This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge. The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups. Providing verbal and pre-formatted written discharge instructions to the patient does not guarantee that the patient understands information provided. The patient must understand the medical information given and participates in their care. The best way to achieve patient understanding is communicating, and reinforcing while acknowledging culture, belief and language barriers.
2
Project Purpose
The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding.
The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet.
The patient and the provider will document the exchange by both signing the discharge tool. The tool will remain in the patient’s medical records.
Cite your slides here
3
Introduction
The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding. The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet. The patient and the provider will document the exchange by both signing the discharge tool. The ...
BENCHMARK 1
Evidence-Based Practice Project: PICOT Paper
Daysha Y. Polk
NUR 550
Grand Canyon University
June 1st, 2021
Evidence-Based Practice Project: PICOT Paper
Generally, a high level of patient satisfaction for the clients in the emergency department (ED) is vital, especially at this time when the healthcare system is shifting towards patient-centered care. Prakash (2010) notes that patient satisfaction levels significantly impact on medical malpractice claims, patient retention, and clinical outcomes. That is, it affects quality healthcare’s timely, efficient, and patient-centered delivery, making it both a proxy but a very effective key indicator for measuring the hospitals and doctors’ success. Consequently, supporting the improvements of patient satisfaction levels can positively affect several healthcare organizations’ components, such as preventive possible malpractice lawsuits, securing a positive local reputation, and enhancing patient retention rates. Thus, there is an increased need to develop strategies to improve ED patient’s satisfaction with the provided care services. Increasingly, the use of real-time location systems (RTLS) by hospitals to track patients, instead of relying on the traditional, manually-entered status updates, is increasingly being viewed as a better strategy to decrease the number or rate of Left Without Being Treated (LWBT) patients, and thus, improve ED patient’s satisfaction levels and hospital’s revenue collection (Boulos & Berry, 2012). Thus, the paper will explore whether the utilization of RTLS in the hospital’s ED, compared to manually-entered status updates to tract patients, help decrease the rate of LWBT and to raise revenue collection within 6 months, for ED patients with decreasing satisfaction levels with the provided healthcare services.
A wide array of factors is responsible for the decreased rate of satisfaction levels amongst ED patients. The current delays, long waits, leaving without being treated, decreased revenue collection from the ED unit, and reduced patient satisfaction scores have negatively portrayed the hospital's reputation to the public. As a result, the daily patient visits have continued to decrease as people attribute the facility to poor emergency care services delivery. All these complications result from the use of combined data resources and manual entry status updates when tracking patient records. This manual tracking cannot meet the demand for many patients and leads to overcrowding due to and reduced patient flow in the ED. Therefore, there is a need to install an automatic patient tracking system to increase the flow.
Patient satisfaction level, especially for hospital’s emergency department (ED) is increasingly becoming a key health quality indicator. Patient satisfaction regards the degree to which patients are happy with their healthcare (Heath, 2016). Patient satisfaction levels is a care quality measure and gives healthcare providers infor ...
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996). For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000). Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013). The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019). The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
Patients' satisfaction towards doctors treatmentmustafa farooqi
The mood of the care recipient to see if the impression (expectations) of service are met by the patient may be defined as patient satisfaction. The current perspective on service efficiency tends to be that patient treatment meets public standards and requirements in terms of interpersonal support as well as professional assistance. (Hardy et al. 1996).
For various reasons, customer satisfactions in the healthcare industry have been investigated. First it was important to decide on the extent and the degree to which patient care seekers, the meeting of drugs criteria and the continuous use of these services have effect, satisfaction as a quality of service metric, as well as allowing doctors and health services to better appreciate and use the input of the patient. (Ong et al. 2000).
Consumer satisfaction with healthcare services is a multi-panel term that refers to the core facets of treatment and suppliers, while PS medical services with the quality enhancement systems from the patient context, full control of quality and the intended outcomes of services are considered to be of primary importance (Janicijevic et al. 2013).
The Pakistani health system is being changed somewhat and there are wonderful scope for applying standard of services to health care. Patients in Pakistan now have access to increased quality health care. Obviously, the staff and staff are the most important winners of a successful health care environment of every community sector framework (Bakari et al. 2019).
The medical clinic of today's study is the product of a long and complicated war of civilization to quantify produce and study and to give thought to the thoughtful (Fullman et al. 2017).
PAGE
Walden University
February 2018
Abstract
The practice problem identified is headache sufferers are not adequately getting their headaches controlled. They are utilizing the emergency room for pain control which only gives them immediate control but not long-term control. The emergency rooms are becoming overcrowded. Controlling headache patients pain will help keep them out of the emergency room and help to decrease the overcrowding of the emergency rooms. Controlling the headache pains will also help decrease costs to consumers and the healthcare system. Case managers can help not only educate these patients, but they can increase better continuity of care and be able to provide feedback to the physicians. The better educated these patients are, the less likely they are to go to the emergency room. The practice problem question to be answered is to examine if an education plan along with a plan of care with primary care provider and network, will assist in increasing headache control and ultimately keep these patients out of the emergency rooms. The purpose of this project will be to implement an education protocol for headache patients to evaluate usage of the emergency department for headache pain control. Models that will be useful for this project are Pender’s Health Promotion Model and the Health Belief Model. These models will help to evaluate individuals and how they interact and behave in order to be able to change their behavior and help them to control their headache pain. This protocol can be included for provider’s and case managers within a clinically integrated network so that a greater number of patients can be managed effectively to decrease emergency room visits. The expected results will be this educational protocol will help patients control their headaches better and will assist in decreasing emergency room visits. The implications of this project will include increased control on headaches, decrease emergency room visits from headaches, and better quality of life for headache patients.
Utilizing Nursing Education and Intervention as a Method to Decrease Emergency Department (ED) Visits for Headache
by
Jodi Raisor
.
Table of Contents
Section 1: Nature of the Problem …………………………………………………………3
3
Introduction
3
Background
4
Problem Statement
6
Purpose Statement
6
Project Question
7
Framework for the Project
7
Implications for Social Change
8
Definition of Terms
9
Assumptions
9
Scope and Delimitations
10
Limitations
10
Significance
10
Summary
12
Section 2: Background and Context
12
Introduction
12
Literature Search Strategy
13
Concepts, Models and Theories
15
Systematic Literature Review Related to Methods
15
Role of the DNP Student
15
Role of the Project Team
16
Summary
17
Section 3: Methodology
17
Introduction
17
Project Design and Methods
18
Exclusion Criteria
18
Inclusion Criteria
18
Data Analysis
19
Protection of Human Rights
19
Summary
21
References
Section 1:.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
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Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
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Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
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"Protectable subject matters, Protection in biotechnology, Protection of othe...
DN 703 Identifying a Target Population Research Paper.docx
1. DN 703 Identifying a Target Population Research Paper
DN 703 Identifying a Target Population Research PaperDN 703 Identifying a Target
Population Research PaperBased on the information provided in Unit 7 discussion, identify
the target population of your DNP project, why you selected this target population, and
analyze the cultural and psychosocial dimensions; environmental factors; demographic
descriptors; health literacy; and if appropriate, the bio-statistical data for the specific target
population. Include in the scholarly paper, a strategy for implementation of the project,
potential outcomes, and an evaluation strategy.Unit 7 discussion was the following:Problem
statementThe Problem is patient returning to the ED because of the alleged inability to
understand discharge instructions, access follow- up care, their concerns on the medical
problem, and its progression. Most patients require resources for completing care that
would get accessed timely through their return to the ED which creates one of the biggest
problems in United States hospitals which is the overcrowded ED. The revisiting of the ED is
now a measure of the adequacy of Emergency Department discharge practices. The short
return to the Emergency Department closely gets monitored. This metric also reflects the
emergency care quality, especially in cases where patients need hospitalization in their
return to the ED. Many of the patients get discharged home after treatment without proper
education or instructions. This investigation identified the issue associated with the adult
population and also the language barrier.Identified needThere are emerging measures
seeking to minimize the number of readmissions to the Emergency Department.
Policymakers and relevant stakeholders who want to reduce costs, improve outcomes, and
promote improved patient experience regard safe transition as an essential goal. The
hospital readmissions are regarded as tools that capture the transition of care deficits in
hospital settings (Cheng et al., 2016). It is now a measure of quality that is now linked to
penalties for poor-performing medical institutions. Several studies group the return visit
rate as poor in marking quality. A study concerning return visits emphasized on patient-
driven aspects. The study also revealed that patients utilize the ED according to their
perception of value. They returned because of the alleged inability to understand discharge
instructions, access follow- up care, their concerns on the medical problem, and its
progression.ORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE PAPERSProposed clinical
intervention or system changeIntervention effort is to involve nurses that can offer detailed
explanations concerning patient discharge to the patients. It will entail the factors that will
arise while the patient will be at home, and how to approach situations that may compel
them to go back to the ED. This will help prevent the patients from going to the ED again.
2. Another short-term solution involves the physicians discussing detailed information about
the illness involved with their patients. The physicians can also properly address concerns
that their patients may have to reduce uncertainty from them and utilize interpreters if
patient speaks foreign language for proper understanding. In the long run, the physicians
and nurses should ensure they create an ED-based care program that will integrate the care
teams in the ED. The program should offer more trainings on handling patients at the ED
including the aspects of discharge to prevent the return cases. Intensive training should aim
towards enhancing the nurses and physician role that includes patient engagement.
Developing a discharge checklist that when patients are about to be discharge from the ED
they can check mark and sign confirming that providers discussed what is on checklist with
patients before they leave the ED. Alternative intervention is to establish a reliable way of
contacting providers after the discharge period via telemedicine. Such methods can assist
patients in managing their concerns without the need to return to the hospital. DN 703
Identifying a Target Population Research PaperDemonstrate how evidence from the
literature search ties the problem or clinical inquiry to practice.For over 20 years,
physicians in the ED are under programs that report the visits back to the ED within 72
hours. Several studies group the return visit rate as poor in marking quality. A study
concerning return visits emphasized on patient-driven aspects. the CDC data offered
insights on this issue. For instance, in 2014, close to 5.7% of the ED visits involved patients
who were previously in the ED in the last three days. Approximately 4.8% of the visits were
due to follow-up. Also, close to 3% of the ED visits were previously there 72 hours before.
The revisiting of the ED is now a measure of the adequacy of Emergency Department
discharge practices. The short return to the Emergency Department closely gets monitored.