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Discharge Planning & Patient Safety | |
Discharge Planning | |
The Center for Advancing Health website brings to light a recent report entitled Snapshot of People’s Engagement in their Health Care published by The CFAH which found that 91% of chronically ill patients did not receive a written plan of care when they were discharged from the hospital. | |
A study reported in The Journal of the American Medical Association followed over 3,300 patients in eight countries diagnosed with congestive heart failure (mean age ≥55 years) for about eight months post-discharge. Researchers concluded for those patients who had been provided pre-discharge planning along with post-discharge support (home visits, telephone contacts, clinic visits, continuous multidisciplinary home care, and day hospital care) the following: | |
"Comprehensive discharge planning plus post-discharge support for patients with congestive heart failure significantly reduced readmission rates and may improve health outcomes such as survival and quality of life without increasing costs."
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The AHRQ (Agency for Healthcare Research and Quality) yielded the following data:
• 20 % of Medicare patients are readmitted within 30 days • 1 in 5 patients in the US is readmitted to the hospital within 30 days • Hospital discharge is not standardized and is marked with poor quality
– Marked with poor quality – Loose ends – Poor communication – Poor quality information – Poor preparation – Fragmentation – Great variability |
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Patient Safety | |
Because Never Events are devastating and preventable, health care organizations are under increasing pressure to eliminate them completely. The Centers for Medicare and Medicaid Services (CMS) announced in August 2007 that Medicare would no longer pay for additional costs associated with many preventable errors, including those considered Never Events. Since then, many states and private insurers have adopted similar policies. Since February 2009, CMS has not paid for any costs associated with wrong-site surgeries. | |
Never Events are also being publicly reported, with the goal of increasing accountability and improving the quality of care. Since the NQF disseminated its original Never Events list in 2002, 11 states have mandated reporting of these incidents whenever they occur, and an additional 16 states mandate reporting of serious adverse events (including many of the NQF Never Events). Health care facilities are accountable for correcting systematic problems that contributed to the event, with some states (such as Minnesota) mandating performance of a root cause analysis and reporting its results. | |
• 1 in 25 patients have a never event- an accident or hospital responsible injury • Costs the US over $29 billion each year • 48,000 to 98,000 patients die each year due to medical errors (Institute of medicine is quoted as saying 98,000 deaths annually) • Example: each pressure ulcer costs a hospital between $700 - $9,000 per occurrence • By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion -in 2007 dollars (AHRQ) • One Fall without injuries cost each hospital $425 (MedScape) • One fall with injuries cost a hospital $6,437 (MedScape) |
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