Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

The Inefficiencies of Department Silos in Healthcare

6/14/2012 7:09:51 PM | 3 comments

Under the current siloed, discrete process of delivering medical care, each physician that participates in the care process is driven by different and sometimes conflicting goals.  Emergency physicians are driven to rapidly diagnose, provide initial management and prep patients for rapid movement from the department.  The goal is to provide the care necessary to as rapidly as possible free up the emergency department bed for the next patient.  They are working in a context of a continual flow of patients and limited time and resources.  

Hospitalists want to make sure that every admission is necessary and directed to the correct inpatient bed, that the patient work-up includes the information necessary to determine all necessary next steps, that admissions are minimally disruptive to their scheduled work flow, and that hospitalized patients receive the care necessary to minimize their length of stay while providing adequate recovery to also minimize the likelihood of readmission. 

Consulting physicians provide care specific to diseases under their domain.  However, office practice and personal demands often dictate specialist availability which may compromise both the emergency physician and hospitalist’s ability minimize patient stay within their respective domains.

It is not surprising that this system has not led to optimal healthcare delivery efficiency, as meeting goals in one silo may create inefficiency in another.  For example, the emergency physician may have the necessary information to disposition a patient to an inpatient setting, but the evaluation may still not contain the information necessary for the hospitalist to determine next steps.  Or, the hospitalist may not want to break his work cycle to evaluate whether an inpatient admission of an ED patient is necessary, creating a delay in clearing the ED bed for other waiting patients. 

Bundled payments for the entire acute care episode will at least create the demand for integration and efficiency across the acute care continuum and force siloed practitioners to work in a unified team environment.  Integrated physician management and coordination across the Acute Care Continuum results in resource utilization efficiencies and improves care resulting in decreased healthcare expense.

ELois P. Clayton
ALERT! Contact information: ELois P. Clayton: (773)622-2906;ANY time! <br /> <br /> Chester MHC(in Chester, Illinois), is a facility, where my brother has been a patient for (18) yeras now;being raped and assaulted in other ways by guards and a few of the inmate/patients there. <br /> <br /> We have learned AGAIN, that there IS a COVERUP of ABUSES orchestrated against him and his "SW" Travis Nottmier, has been asked to be REMOVED, as his Social Worker, for he has PROVEN to be involved in FORCED PSYCHE drugs and COVERING of assaults (violation of his EIGHTH AMENBDMENT RIGHTS;'Cruel And Unusual Punishment') <br /> <br /> This REQUEST was addressed by way of CERTIFIED LETTER from I(Davids' sister), TO the (now) Head Adminsitrator(Brian Thomas). <br /> <br /> This is only a small example of the assaults we have documented. <br /> <br /> I have MORE medical records PROOFS/PHOTOS of INJURIES orchestrated on David. <br /> <br /> PLEASE VIEW my PETITION and ask others to sign for Davids' sake, for his HEALTH IS failing and we are also concerned for his COGNITIVE abilities, for THIS is one of the reasons WHY we docuemnt the events that occur with him at CMHC. <br /> <br /> Thank you. <br /> <br /> We(Daid's family), is STILL seeking a 'Human Rights' attorney, to represent him in a Human Rights case AGAINST this facility. <br /> <br /> The "medical team", being that PSYCHE drugs are FORCED on David (and I'm sure others), is an indication that medicare/caid FRAUD DOES exist at Chester MHC. <br /> <br /> <br />
10/3/2012 2:27:53 PM

I'm an UNemployed Certified Medical Coder/MT AND CADC! <br /> <br />My concerns are that(1), patients receive the BEST of care, when hospitialized AND that they can afford to be hospitalized, which CAN be worked out, IF the "doctors" STOP UNbuldling procedures that SHOULD be bundled! <br /> <br />This action, causes many ELDERLY patients to make rash decisions as to whether they should by FOOD, medicine OR pay their mortgages and this should NOT be a difficult decidsion for them to make because of FRAUD in the 'medical' field!
10/3/2012 2:14:21 PM

Perspectives on the Acute Care Continuum
Trackback from Perspectives on the Acute Care Continuum<br /><br />By Jeff Bass, MD
Health care spending now represents greater than 16% of our Gross Domestic Product, up from 13% in 2000.  It is continuing to grow, some say at the rate of  1.5 times GDP.  As we approach the 20% benchmark, we need to... ...
7/24/2012 9:21:11 PM