Opening the lines of communication between clinicians and specialists to make care more efficient can be a sizable challenge.
At many facilities, hospitalists shuttle from floor to floor to see patients, each time trying to track down the nurse and other professionals working on each case. Information is typically transferred through an inefficient system of pages and phone calls, sometimes taking hours at a time to deliver crucial pieces of information.
Enter the accountable care unit, a new way of configuring care systems that can help to uncoil tangled communication wires between clinicians and support staff to provide care that is more efficient and streamlined.
In this model, hospitalists work with patients in a specified geographical area of the hospital in conjunction with interdisciplinary teams.
Having patients in one area helps make care more efficient, and as one hospital system in New Mexico learned, can also reduce length of stay and increase cost-efficiency.
Regionalization of hospitalist patients is becoming more common today, because of the benefits it's been shown to bring, says Stefani Daniels, RN, MSNA, ACM, CMAC, founder and managing partner of Phoenix Medical Management in Pompano Beach, Florida. Those benefits include:
Improved teamwork, care coordination, and communication
Fewer readmissions
Improved resource management to lower cost of care
Improvements in patient satisfaction
Reduction in inefficiencies
"I'm pushing accountable care units at all my hospital clients," says Daniels. But while the will is there in many cases to make the change, it's not always an easy conversion.
Sometimes these initiatives face pushback from physicians concerned about personnel or scheduling issues.
Other challenges include:
The lack of diagnostic diversity that results from having set teams on a unit
The challenge of deciding whether teams should be flexible or static
Hammering out logistical issues, such as how patients should be triaged and how beds are managed
With only 60 days between the OPPS final rule's release and the January 1 implementation date, providers will be ahead of the curve by spending time now and thinking about the processes they may need to review, change, or implement based on what CMS finalizes and the sort of financial impact the final rule is likely to have.
Just like the lyrics to the popular Gap Band song say, "You dropped a bomb on me… I won't forget it," there are definitely some changes in the 2017 ICD-10-CM Official Guidelines for Coding and Reporting that some of us may wish the Cooperating Parties will forget were ever mentioned.
In a year of high-profile, multimillion dollar settlements for large HIPAA breaches, OCR raised the stakes in a big way—by taking a harder line on small breaches. OCR announced plans to crack down on smaller breaches—those affecting fewer than 500 individuals—in August.
Orders for services are a vital component of ensuring Medicare coverage. With the advent of computerized provider order entry (CPOE), it is important to review order templates in the electronic medical record (EMR) and the resulting order produced or printed in the formal legal medical record to ensure the templates meet requirements.
