The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.
Patient handoffs between the emergency physician and hospitalist involve some of the most crucial transactions in the Acute Care Continuum. When communication is clear and direct, it's likely to lead to better patient satisfaction, higher quality of care and a shorter length of stay.
On the other hand, holdups and miscommunications can have a negative impact on safety and quality. In one study published in the Annals of Emergency Medicine, 40 out of 264 physicians surveyed reported that they had dealt with an adverse event following an ED-inpatient transfer.
In my previous post, I discussed some of the challenges physician leaders face in shaping organizational culture. Today, I'll outline some practical steps physicians can take to begin the process of leading change.
In assessing the current culture, a new medical director should seek to understand the strengths, weaknesses and opportunities for improvement. It is important to talk to the staff, leaders and providers to understand the current culture and why its participants act as they do.
Altering a dysfunctional emergency department (ED) culture is possibly the toughest task a medical director might face. Changing entrenched organizational behavior is a difficult undertaking — and not something taught in medical school.
Post-Acute Care in a Post-Fee-for-Service World
With more beneficiaries enrolling in Medicare Advantage, post-acute providers are suddenly finding themselves struggling to survive. Previously, most post-acute facilities billed only Medicare and Medicaid. However, they are increasingly having to deal multiple managed care plans — all of which pay at different rates and in different ways — due to state-specific Medicare Advantage requirements. This additional administrative burden is proving costly for these facilities, which have neither the experience nor the resources to deal with private payers in the same way hospitals and physicians do. As a result, the number of post-acute facilities has been declining as more of them are unable to handle the variability that comes with these new requirements.
It's amazing how important 21 simple questions have become.
The HCAHPS patient perspective survey has risen ever higher on the priority list of healthcare administrators and practitioners as it has moved from a CMS pay-for-reporting system to a pay-for-performance system in 2013. Yet, despite many years of focus, training and communication, many are still struggling to attain the HCAHPS scores they desire. Why?
The "knowing-doing gap" is the reason so many have hit a ceiling with their HCAHPS scores.
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Congratulations on a job well done. Love your focus on the patient experience!