The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.
As a registered nurse, I am aware of the importance of making patients feel comfortable and well cared for. We all know how important patient satisfaction is to our hospital administrators and the federal government. But while we focus heavily on being in the top percentile on patient satisfaction metrics, I think we sometimes lose sight of who and what is at the other end of those numbers…until the "who" is us.
For me, a much-awaited scuba diving vacation in Indonesia turned into an eye-opening experience. Let's skip the gory details and just say that I ended up in Mount Elizabeth Hospital in Singapore with a bacterial infection. The hospital could have been anywhere in the United States — and in fact was nicer and more modern than many I have visited across our country.
State Health Exchanges Experience Own Set of Problems
As President Obama's administration works to fix the problems plaguing the federal Health Insurance Marketplace's website, states implementing their own health insurance exchanges are reporting both successes and glitches. California, Connecticut, Kentucky, New York and Washington have all seen "robust enrollment" since the October 1 launch, with California reporting nearly 80,000 individuals signing up in the first month. However, Colorado and Oregon are reporting low enrollment and website issues respectively.
As a nurse leader, I once overheard staff talking about a certain nurse who was abrupt with a patient when he tried to give her a lengthy explanation of his condition. In the past, I had observed this same nurse being somewhat curt with colleagues, and several patient surveys had described "rude" behavior by this person.
Though red flags were waving, I was reluctant to act. Rarely does a leader take their role because they excel at or enjoy confronting members of their team. Even those of us with years of experience can think of reasons to postpone a conversation with a team member who is derailing our team's success.
The Centers for Medicare and Medicaid Services' (CMS) proposed assault on emergency department (ED) and outpatient facility levels has been well documented in Perspectives on the Acute Care Continuum. CMS claims its proposed move to a single facility level will simplify claims management and coding, while also deterring some of the "upcoding" CMS claimed hospitals were undertaking.
However, recent increases in acuity levels coded by EDs nationwide — and the costs associated with that increase — are certainly additional factors.
Where Do Physician Groups Stand on Healthcare Reform?
At the Becker's Hospital Review 5th Annual CEO Strategy Roundtable on November 14, panelists discussed how healthcare reform affects ambulatory surgery centers and physician group practices. Wesley A. Curry, MD, CEO of CEP America, noted that he believed there will only be a slight uptick in patient collections as a result of the Affordable Care Act. "The ACA will not manufacture more patients, but it will shift the representation of our payer mix," he said. Dr. Curry also reiterated that many hospitals will look to emergency department physicians and hospitalists to stand as leaders in the push for integrated care. "ER physicians are the first point of patient contact. Combine this with hospitalists, and this accounts for 85 percent of hospital admissions," he said. "I think most forward thinking hospital administrators will see ER physicians and hospitalists as a unit."
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