This paper will describe the Long Term Acute Care Hospital (LTACH) which is affiliated with Carson Tahoe Hospital (CTH). Long Term Acute Care hospitals were essentially non-existent in 1979. Now, there are over 450 facilities nationwide that are licensed as LTACS (McDaniel, n.d.). The discharge plan I will be describing is for a 66-yr-old female who was admitted to (CTH) for revision of a chronic enterocutaneous fistula which was draining from her abdomen through a very large open wound. This fistula developed as a complication of a subtotal colectomy for ischemic bowel which was performed in February 2012. When the fistula first developed following the colectomy, she was admitted to LTACH with the goal of draining the fistula. Because this was unsuccessful, she returned to Carson Tahoe Hospital to determine the source of the leak and subsequently repair it. She is on a TPN diet, is NPO and is on contact isolation due to a Strep B infection in her wound. The revision surgery was done on April 29, when it was discovered that there was a 1.5 cm ulcerated and perforated area on the anterior portion of her stomach. This gastric percutaneous fistula was repaired and she will be discharged back to LTACH for ongoing IV antibiotics and wound care.…
Hospital researchers may find that incorporating the LACE Index into a CDS program will make a beneficial addition to the hospital's information system. For instance, these hospital researchers have noted that there has been a steady increase of CHF patient readmissions over the last five years and has, therefore, chosen to implement a preventive measure to decrease the high readmission rate of this patient group. The hospital will aim to establish steady communication with the primary care physician (PCP) of the CHF patient concerned, to advise the PCP to take preventive steps to stop an avoidable…
There are several good things that come out of this act and they include that health care is more affordable for millions of people across the United States. ObamaCare prevents insurers from increasing premiums to unaccommodating prices so that people are able to buy health insurance. Another positive impact from this law is that the prices of prescription drugs decreased significantly. This resulted in senior citizens, along with others to be able to purchase these originally expensive medications. The last pro of this law is that…
References: Health expenditures as a share of the GDP and per capita. (2009) [Graph illustration 2005]. Retrieved from http://oecd.com…
Many seniors rely on their provider to on top of their health for them since many of them have a hard time keeping track of their conditions, treatments, and medications on their own. It seams to me that Pay-For-Service systems are a start in the right direction but it is more likely that a system that has both elements of Fee-For-Service and Pay-For-Performance would be a good balance. Both incentive systems have their flaws and bring up concerns, but the two together with some tweaking there and there might be a better solution. Unfortunately there will never be a perfect health care system it is just to complex to be able to work out every solution to every possible issue. Even though there will never be a perfect solution to our health care system I believe we could come close some day. We need to look at what has worked and what has not worked and build off that keeping the politics out of it and focus on what is best for the patients and the providers, not the insurance companies or the government. Referneces Baker, G. (2003). Pay for Performance Incentive Programs in Healthcare.Market Dynamics and Business Process,(), 3. Blum, E. (2006,November). Is pay-for-performance a viable way to improve patient care and safety.American…
The combined program (IVIP and Clubhouse Services), unlike the standard services, also involved three, one hour a week of courses and group which utilized cognitive behavioral therapy psychoeducation to address the disempowering beliefs and thoughts as well as identifying/modifying cognitive distortions members had about their ability to work and adapt into community (i.e. “I am terrible at work and I cannot perform my job” and “I never will be able to work like everyone else; I am inadequate”) (Lysaker et al., 2005). The researchers utilized The Bech Hopelessness Scale, The Rosenberg Self-Esteem Scale, and The Work Behavioral Inventory which is a 35 item tool designed to measure the quality of work values and outcomes of the…
It has begun the process of equaling the playing field between insurance companies and healthcare providers. It is going to help tremendously with Medicare and Medicaid programs in reducing costs, by managing care and bundling services for members. Also, by increasing the number of insured people unnecessary medical costs for non-life threatening visits to the emergency room will decrease whereby offering relief to hospitals and the individuals. Furthermore, by expanding health care services individuals may not be so chronically ill before receiving care, which helps lower costs and improves the quality of life for many. It will take time to fix the system. It was not broken overnight and therefore will not be fixed overnight either. I see many more reforms to come and ultimately an increase in taxes, but if that is what it takes to help this system than we all need to take responsibility for it. The ACA is at least setting the stage for much needed reform to an otherwise failing…
“A reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs” (Shi & Singh, 2012). Pay-for-performance is being turned to by payers and those who make policies. The P4P initiatives objective is to reimbursement to excellence and effectiveness to increase health care quality and to decrease costs. Agencies of the government are starting programs for providers to be encouraged to encounter excellent values. When there is improvement in care and effective performance by providers, the providers may see financial rewards. It was expected that hospitals would respond to P4P incentives, but there is little evidence that this has happened.…
Obamacare was signed into law on March 23, 2010 by President Barack Obama. The ACA was designed to offer healthcare to all groups of American citizens, mainly to the upwards of 30 million uninsured Americans. Although there were several reasons this reform was necessary there were a few main reasons that seem to stand out. Being able to offer health insurance to those that suffered from pre-existing conditions as well as not put limitations on the amount of coverage these Americans could actually maintain and keep. It wasn’t unheard of to be capped to a certain amount of coverage once a patient became sick. The US Census Bureau (2011) estimated there to be somewhere around 49 million uninsured Americans in 2010, so this reform would cut down on that number…
The Centers for Medicare and Medicaid Services have taken on initiatives to improve quality of care for Medicare patients since the Affordable Care Act was passed in 2010. In 2012 CMS implemented a program called The Hospital Readmissions Reduction Program (HRR), this program is intended to improve health care for patients with Medicare to improve the quality of care that is provided versus the quantity of care. This program provides incentives to hospitals, which is intended to reduce costly and unnecessary readmissions (Centers for Medicare and Medicaid Services, 2016). The conditions that are currently being monitored by CMS for readmissions are heart attack, heat failure, and pneumonia. If hospitals have a high percentage of readmissions…
Efforts are being implemented by the CMS to decrease cost and advocate quality care. First, the Hospital Value-Based Purchasing ( VBP) program, in which compensates acute-care hospitals with impetus awards for quality care provided. Second, Bundled Payment for Care Improvement (BPCI), which combine reimbursements for various services provided at the time of treatment. Lastly, Accountable Care Organizations (ACO) are associations of physicians, hospitals and other healthcare professionals who voluntarily join together to provide a systematic quality of care to their beneficiaries.…
The Affordable Care Act is considered one of the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law employed comprehensive reforms designed to improve the accessibility, affordability, and quality of health care.1 The ACA has not affected health outcomes directly, however, access to care has improved and readmissions rate has dropped which reflects methods of processes of care.…
The Affordable Care Act (ACA) also known as ObamaCare, has several provisions that are intended to find solutions to underlying issues in the United States as to how the health care is delivered to patients and how the health care provided is paid for. These previsions made in the ACA focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for system wide improvement. An example of a new model for delivering health care is the Accountable Care Organization (ACO). The ACO is a group formed by health care providers ranging from primary care physicians and specialists to hospitals and post-acute care facilities that…
I believe there are positives and negatives with the affordable care act. The Affordable care act was enacted in 2010 and its main focus revolves around the idea that "healthcare is a right, not a privilege" (Wilbanks, 2014). In the 5 years since the ACA was enacted, about 3 million uninsured people under 26 have become insured through their parents and more than 30 million Americans are now insured thanks to the additional protections against preexisting conditions and terminating policies due to illness (Blumenthal, Abrams, & Nuzum, 2015). The rise in coverage and eliminating judgment based off of conditions that people have, is a step in the right direction I believe. However, there are still drawbacks. The Affordable Care Act is…
The Obama care is heading in a positive direction. The new health care plan is designed to provide…