financial accountability of healthcare organizations for preventable readmissions. Hospitals have increased their awareness and are looking for system ways to assist in the reduction. The Centers for Medicare and Medicaid Services (CMS) have initiated a process for decreasing the reimbursement for readmitted patients within a 30-day period. CMS identified readmission measures for applicable conditions of acute myocardial infarction (AMI), heart failure (HF), pneumonia and in 2015 chronic obstructive
For patients who have an acute coronary syndrome with or without ST-segment elevation, are being treated with Brilinta (ticagrelor) rather than Plavix (clopidogrel) significantly reduce the risk of thrombotic cardiovascular events? After an acute coronary syndrome (ACS) event, patients are potentially at risk of further ischemic events for a considerable period time. These events may include unstable angina, non-ST elevation myocardial infarction (NSTEMI), acute MI (STEMI) or percutaneous coronary
to ineffective health care delivery, cost of adverse events, and poor care coordination that has led to avoidable readmissions (Lallemand, 2012). In the United States, readmissions are the highest amongst patients with chronic diseases accounting for about 90% of avoidable readmissions in 30 days after discharge, and costing the industry an estimated $17 billion. These readmissions are a result of inadequate discharge planning, lack of follow-up, and lack of education on disease management (Jayakody
Heart Failure (CHF), older patients may receive care in multiple settings; often resulting in fragmented care and poorly-executed care transitions. The negative consequences of fragmented care lead to duplication of services; inappropriate or conflicting discharge instructions, medication errors, patient/caregiver anxiety, and increased costs of care. In light of changes in Medicare reimbursement penalizing hospitals with above set limits for heart failure (HF) readmissions, models of care are being
Hughes (2008) quoting from the , the Agency for Healthcare Research and Quality handbook stated that “many view quality health care as the overarching umbrella under which patient safety resides”. Friedman, Encinosa, Jiang & Mutter (2009) found that “safety events that result in hospital readmissions lead to hefty a financial burden on the institution”. In addition they believe that if more attention is given to address and “ assess the full extra cost of safety events and the factors influencing
Cost Nurses have the power to increase positive patient outcomes by implementing changes in their practice based on the evidence found in the nursing literature. Utilizing evidence-based practice (EBP) increases nurses job satisfaction, increases communication across the interdisciplinary team, enables nurses to provide their patients with high-quality care and decreases health care cost. The purpose of this paper is to describe why readmissions from nursing homes (NHs) is a nurse practice problem
Teaching and Patient Outcomes The transition from acute care to home presents many concerning issues for patients, families, and the healthcare system. According to the Agency for Healthcare Research and Quality (2009), one in five patients experience preventable complications once discharged from the hospital. Complications experienced after discharge are a strong indication that patients are unable to manage their discharge plan (McBride & Andrews, 2013). As a result, patients are often in
Executive Summary The idea that the healthcare reimbursements should be linked to the quality outcomes and performance measures is central to the Patient Protection and Affordable Care Act. The legislation provides various reforms that either provide incentives to healthcare providers for better quality services and outcomes or reduce their payments if certain quality standards are unmet. This paper talks about the different reforms under PPACA, aimed at introducing payment variations based on quality
Heart failure is a clinical syndrome characterized by structural or functional impairment of ventricular filling or ejection of blood resulting in insufficient perfusion to meet metabolic demands; most commonly results from impaired left ventricular myocardial function; cardinal manifestations include edema, dyspnea, and Fatigue4•5 CLASSIFICATION • Classification by American College of Cardiology Foundation/American Heart Association {based on structure and progression of disease) 4 o StageA - At high
(Committee on Quality of Healthcare in America (Institute of Medicine), 2001). The exasperation level is continuously rising amongst both, the patients and the providers, and yet the problem of delivering and receiving high quality care remains unaffected. In order to address this problem of healthcare quality improvement and affordability, the Patient Protection and Affordable Care Act (PPACA or Obamacare) was signed in