Physician documentation must include sufficient detail to ensure that case managers can accurately estimate LOS, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent health information management consultant in Madison, Wis.
Ensuring detailed documentation isn't important only with respect to documenting medical necessity. Case managers should also ensure physicians are including enough information in patient records to help them accurately estimate LOS, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent health information management consultant in Madison, Wis.
Successful programs to reduce preventable hospital readmissions range from the transitional care model created by Mary Naylor, PhD, FAAN, RN, a nurse researcher at the University of Pennsylvania, to Project RED, created by the Commonwealth of Massachusetts. Kathleen Heery, MS, RN, CCM, and Cheryl Pacella, DNP(c), HHCNS-BC, CPHQ, the homecare consultant and quality advisor at CAP Consulting, LLC, discussed the secrets to their success during "Reducing Readmissions by Improving Transitions in Care," an HCPro webcast.
How quickly time flies! As 2012 has now come to an end, it seems to be a good time to reflect on some of the challenging standards hospitals faced this year.
You're reviewing a case file and discover that a patient's recent readmission is due to a medication prescribing error made by a physician. Do you report it?
There are six generic approaches to managing risk, and the approach an organization chooses to use will depend on many factors. For example, how real is this risk? Can it actually become a problem, or is it merely theoretical? Management will want to decide whether the risk is likely to happen and whether it is possible to determine when it may happen. This will also assist in appropriate allocation of resources to focus on material risk areas.
