CareGroup was formed in a three way merger of hospitals in 1996, becoming a health-care team dedicated to providing personalized care to patients through a broad spectrum of available services. The merger was precipitated by increased need for negotiating and contracting power to respond to the HMOs, the possibility of developing integrated services to improve quality of care while driving down costs and the need for a strong balance sheet. The hospitals involved in the merger had experienced recent losses under their own separate management and the merger brought financial stability and central leadership.…
There are a number of business challenges in healthcare such as service quality, safety, rising costs, a severe shortage of skilled staff in order to meet the needs of patients with a complex burden of illness. To meet the challenges in front of us, will require a shift from acute care to more preventive and long-term chronic care management. This new care model must be supported by interoperable health information technology and a more patient-centric care system. www.cisco.com/web/strategy/docs/healthcare/07CS1034_HC_Whitepaper_r5.pdf…
Subjective Data: He has loose watery stool for the past 12 hours, CHF, perineal area has become excoriated and tender.…
Changes in U.S. demographics bring about a shift in the way patients view the care needed and the avenue they chose to take for extended care. With an ever increasing shift in the economic situation, individual providers are challenged with dealing with a wider range of medical conditions, some of which cannot be alleviated by the advancement in medical technology. The healthcare organization faces the challenge of providing necessary space to accommodate the demand for the increase in population.…
One of the most significance aspects of the medical profession is its ability to adapt to change and the flexibility of unending evolving multifaceted health care system. With the shortage of health care providers in the primary care settings and the increase of geriatrics population seeking care, mid-level clinicians (nurse practitioners) will serve as a practical resource for managing the elderly patients. This proposal aim to seek partnership agreement between Icecat family group (IFG) and Nneka family group (NFG) nurse practitioner to provide patient centered medical home services (PCMH) to IFG Medicare and Medicaid elderly patients, using patient family members as a frontline care givers. PCMH is a way to organize primary…
As a Clinical Case Manager, this author understands the value of controlling costs. These efforts enacted by payors require institutions to develop more efficient business models and delivery of care systems, and managed care efforts help to control costs. Hospitals are focusing on…
Centers for Medicare and Medicaid Services (CMS), is clinical indicators focused on improving clinical outcomes. CMS is concentrated on physicians, nursing homes, long - term care facilities, home care, and hospitals. The information obtained can be compared to other hospitals and target locations, medical conditions, outcomes, surveys, and payment information. Giving administrators and researcher’s valuable information directed toward positive or negative outcomes (Wager, Lee, Glaser, & Burns, 2009).…
Hospitals recognized the need for the case management model in the mid 1980’s to manage the lengths of stay of hospitalized patients and the treatment plans (Jacob &ump; Cherry, 2007). In 1983, the Medicare prospective payment program was implemented which allowed hospitals to be reimbursed a set payment based on the patient’s diagnosis, or Diagnosis Related Groups (DRG), regardless of what treatment was provided or how long the patient was hospitalized (Jacob &ump; Cherry, 2007). To keep the costs below the diagnosis related payment, hospitals had to efficiently manage the treatment provided to a client and reduce the client’s length of stay (Jacob &ump; Cherry, 2007). Case management, or internal case management “within the walls” of the health care facilities was created…
With the elder population living longer, the medical field needs to expand to meet the demands of the homebound patient. According to a study by Auerbach (2012), he projects the APN workforce will continue to expand a steady rate reaching 200,000 by 2020 and 236,000 by 2025. At the time the study was conducted in 2012, there were 128,000 APN’s. Having a home-care based practice is only one way to ensure homebound individuals are properly cared for and is guaranteed medical attention. One advantage of home-care visits alleviates the burden of the family of trying to find transportation to a physician’s office. Not only will APN’s home-care visits be convenient for homebound patients, it will be very cost effective as well. Naylor and Kurtzman (2010) assumes that the average cost for the APN visit is 20–35 percent lower than the cost of a physician…
The process of ACP is a reflection of society’s desire to respect personal autonomy. The content of any discussion should be determined by the individual concerned. The individual may not wish to confront future issues; this should be respected…
The development of a care plan agreed by all involved, including the person her/himself and any informal carers, as far as this is possible, and addressing the assessed needs…
The world of nursing is constantly changing to meet the needs of health care in the United States. As it evolves, nurses are instrumental in this transformation process. According to the Institute of Medicine’s report on nursing’s future, nurses will play a critical role in providing quality care at a lower cost. As legislation is moving health care away from acute and specialty realms, there is a higher demand in primary care centered environments. (“Future of Nursing,” 2010). There is also a substantial aging population with the baby boomer generation that will need long term and palliative care. (“Future of Nursing,” 2010). According to three health care systems, Veterans Affairs (VA), Geisinger Health System and Kaiser Permanente, emphasis has been put on registered nurses and nurse practitioners to see if moving them into primary practice environments would assist in the delivery of their outcomes. The results from all three health systems showed impressive results with the end result being that of higher quality care and lower economic costs. (“Future of Nursing,” 2010). In order to achieve this outcome, patient to nurse ratios would need to be decreased to meet the demands needed by other disciplines to ensure that optimal care is being given to the patient. With a lower patient load, there would be more time available to focus on the patient from all aspects of care. Implementing a discharge nurse to facilitate the needs of the patient in a timely manner would assist in keeping costs down. The collaboration of case management and the discharge nurse working together would help alleviate the need for readmission. These implementations would meet the goals of the IOM’s report.…
1. Unit-Based Care Manager - Serving as both a facilitator and mentor, the Unit-Based Care Manager serves as the unit’s “attending” nurse with respect to triage, communications, and all clinical needs. The Care Manager is staffed by a Clinical Nurse Leader…
• Proactive in the care of themselves or the care of their loved ones by…
The most important population trend is aging. This is a disaster in the healthcare system. More and more people are getting older and are need of healthcare. Aging is not only important but it has a major impact on the organization and delivery in healthcare. One particular importance that will affect the financing and delivery is the shift from acute to chronic illnesses. Rather than acute illnesses, the focus will be on diseases such as Alzheimer’s disease, heart disease, and osteoporosis (William & Torren, 2008). First, there will have to be a plan to change the style of treatment to an ongoing process. Second, there will have to be a financial plan set in place for disabilities, like long-term facilities such as nursing homes, home health,…