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  • Hospital Impact - Engage patients to survive the turbulence of value-based care
    care assignment requires a physician order admit to inpatient status Person is admitted to a hospital for bed occupancy for the purposes of receiving inpatient hospital services based on severity of illness and intensity of services Must be patient specific Intended for more than 48 hours Services cannot be rendered in a less intensive level In addition an outpatient patient status for observation services will have an impact on a Medicare MCR beneficiary s benefits if he or she transfers to another setting such as a Skilled Nursing Facility SNF We are obligated to explain to MCR beneficiaries their overnight stay in the hospital was for outpatient services and would not meet the technical requirement for an SNF inpatient admission Medicare beneficiaries require three overnights as an inpatient in order to have their insurance pay for the SNF care Hospitals employ care managers and utilization review staff who review the medical record documentation and discuss the care regimen with the physician to ensure the patient is placed in the appropriate level of care status Patients struggle with understanding the difference as they are in a hospital bed and have stayed overnight To them they are admitted The difference lies in their co payment responsibility which can vary from hundreds to thousands of dollars Hospitals push back hard on observation status especially when they have provided a battery of tests that cost thousands of dollars but can only bill for a fraction of the cost Physicians are caught in the middle when they know a MCR patient needs extended care in an SNF but the patient did not meet the inpatient level of care status and the patient and or family cannot afford to pay out of pocket for care at the SNF As the country moves toward a value based care delivery system hospital admissions will decrease and so will their revenue Physicians will move toward a patient centered medical home model of care which is a team based approach to care led by a personal physician who provides continuous and coordinated care throughout a patient s lifetime to maximize health outcomes This is a complete shift in thinking and practice in which physicians who once sent patients to the hospital for complex care are now being asked to provide that care in an outpatient setting This has created more than turbulence for many healthcare organizations Hospitals that once counted on a certain number of admissions are now scrambling for other revenue streams and physicians feel like they are losing control and their patients are caught in the middle Interestingly enough when I talk with my healthcare colleagues and friends it becomes increasingly clear that much of what stresses us out on a daily basis is this battle for control The struggle can be as macro as trying to get a payer health insurance company to agree to a level of care we feel meets the patient s needs and reimburses the hospital appropriately for the care provided or as

    Original URL path: http://www.hospitalimpact.org/index.php/2015/04/08/engage_patients_to_survive_the_turbulenc (2016-02-10)
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  • Hospital Impact - Great leaders must learn, grow from mistakes
    We all know and understand there are times when you need to be behind a closed door but this must be balanced with walking leadership rounds What better way to assess challenges offer encouragement and applaud success than in real time This can and should become part of your repertoire As you learn to trust and delegate initiatives to your direct reports you will foster teamwork and two way communication thus empowering your staff to grow the next generation of leaders Have a vision Great leaders have a plan for themselves their team and the organization They must be able to effectively communicate all three to their team Vision often requires stepping out of your comfort zone in order to move forward Great leaders understand this often requires taking a risk but are willing to embrace these challenges as learning opportunities Be realistic and encouraging When a leader ignores the obvious he sends the wrong message to his team This breeds complacency and discontent within the team Leaders need to sit in on meetings round table discussions and conference calls and pay close attention to the team s dynamic You cannot be afraid to reassign team members especially if they are not actively participating and contributing to the overall goal Sometimes disruptive innovation leads to a more progressive and positive outcome and you cannot and should not shy away from taking this step The most effective strategy in assembling and managing a group of people to work together is to make each person feel like an essential part of the team When each person feels part of something bigger they are motivated to link their success to the success of the group A high morale is contagious It improves a group s cohesion making it more powerful Re fuel your tank Great leaders need to take time to recharge their personal and professional batteries Professional growth is important You need to attend workshops conferences webinars etc It is vital to be amongst your peers to share and learn from one anotherâ s experiences Lastly personal vacation time is of utmost importance The greatest leaders learn from each other These lessons learned not only benefit themselves but their teams as well Leaders must propel the team forward fueling their excitement and making them hunger for new business Great leaders will continue to evolve within this ever changing healthcare environment and new leaders will emerge as long as we continue to be visible and emulate the behavior we want others to follow Darlene A Cunha R N is an accomplished senior healthcare executive who focuses on population health management and the patient caregiver experience Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with

    Original URL path: http://www.hospitalimpact.org/index.php/2014/12/18/great_leaders_must_learn_grow_from_mista (2016-02-10)
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  • Hospital Impact - Become an influential healthcare leader
    Partners HealthCare The list could go on and on Just as I had suspected many of the names on my list have appeared in several publications for their dedication and influence in health and human services What about the individuals who don t have the political clout of those mentioned above but are equally influential highly successful and accomplished in their field Individuals such as physicians nurse managers directors chief nursing and chief executive officers of which many had influenced my career Without their support guidance and mentoring I may have settled into a career of convenience and not one of leadership with a fierce determination to never settle for the status quo There is much to admire about leaders who mentor others and value their craft These are the people who now create history I asked myself Am I one of them Do I measure up to these folks who write the first chapter of the rest of our lives I would like to say yes In my own small way I believe I made a difference I mentored stood up for the underdog and fought hard to change the status quo with passion commitment and focused enthusiasm I learned early on that no matter your age if you have something to say find someone to help you translate exactly what that something is It is my mission to help restore healthcare across the continuum from one of fragility to one that is engaging sustainable and strong My colleagues define my leadership as authentic a combination of courage compassion strength vulnerability passion steely discipline and unfailing loyalty My goal is to become an influential leader by closing achievement gaps in clinical leadership and igniting the passion I feel in healthcare for generations to come No matter our station in life I firmly believe we are bound by a moral obligation to one another After reading the Time issue I could easily add the following traits influential people possess They Embody integrity honesty kindness and decency Surprise others and themselves with what they will do next Consider past achievements and failures as building blocks of great things to come Present a relentless work ethic drive and discipline Are resourceful Act with humility insight and cherish family and life Believe empathy is the most revolutionary emotion Many of us may not have the political platform or financial backing of world leaders but each one of us is influential in our own way I challenge you to make your mark Be courageous curious inspired and creative Never cease to give your best for there are no second acts in life Keep in mind becoming a person of influence is a journey remember to take time to stop and smell the roses along the way Darlene A Cunha MMHC BSN RN is an accomplished senior healthcare executive who focuses on population health management and the patient caregiver experience Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your

    Original URL path: http://www.hospitalimpact.org/index.php/2014/05/22/become_an_influential_healthcare_leader (2016-02-10)
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  • Hospital Impact - Daily feedback more effective than annual performance reviews
    evaluations they can believe not the fraudulent ones they receive They need evaluations that reflect their accomplishments and opportunities for growth not just a date on the calendar They need evaluations that make them strive to improve not pretend they are perfect Sadly many managers are unaware of the havoc they wreak with performance reviews To some extent they don t know any better This is how performance reviews have always been done and this is how they will continue to deliver them Performance reviews were are regarded as the sole determinant of your work They send employees the message that the boss s opinion of their performance is the crucial determinant of pay assignment and career progress Unfortunately we all know that assessment is not always objective When great still isn t good enough A performance review deserves honest performance feedback Great may not be good enough especially when the people saying You re great really don t mean it No employee deserves to be caught off guard by the pink slip If they were told all along they are great they will want an explanation as to why great isn t good enough We do such a disservice to our employees if we don t let them know where they stand professionally Consider this Millions of Americans are out of work right now and struggle to accept what happened to them They spend their days asking Why me and What could I have done differently The sad truth is they never saw it coming because they were convinced as long as it wasn t a performance issue they were safe They assumed doing a great job was all the insurance they needed to stay working In an effort to keep employees happy many managers tell them they do a great job even when they aren t Let s think about this for a moment How many of you take the time to coach your employees on how they can do better There is an important lesson to learn here It s better to be respected for your honesty than lie to be liked Trust me that s hard for a type A woman who likes to please everyone but it was one of the best professional lessons I ever learned Darlene A Cunha R N is senior healthcare executive who focuses on population health management and the patient caregiver experience Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks to limit stressors for autistic

    Original URL path: http://www.hospitalimpact.org/index.php/2014/11/26/daily_feedback_more_effective_than_annua (2016-02-10)
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  • Hospital Impact
    professionals ranked meetings as the No 1 office productivity killer Bad meetings waste time squash employee engagement and get in the way of what your organization s success Ask yourself how many meetings you attended either in person or virtually and left the meeting feeling it was a waste of time I can t tell you the number of times I disengaged from meetings because it was unorganized and thus became preoccupied with the mountain of work I had on my desk Recently I attended a meeting that dragged on and on Everyone sat fiddling with his or her smartphone and Joe from accounting hijacked the meeting for his own agenda Almost everyone in the room was wondering the same thing Why am I even here This prompted me to revisit this topic Read more Leave a comment Who should run a hospital Doctors or nurses July 24th 2014 by Darlene A Cunha Recently I sat in on an interview for a vice president of nursing position at a community hospital During the interview the chief hospitalist asked the candidate with a sense of fervor Who do you think should be running the hospital the nurses or the doctors I have to admit I was stunned given the changes in healthcare and the presence of more nurses in hospital leadership roles However he was serious The New England Journal of Medicine raised the issue in The Doctor Nurse Game Revisited some 24 years ago Clearly we still haven t moved forward This rigid hierarchy that places physicians firmly in charge even though nurses regularly offer expert advice about patient care should be extinct By engaging in this characteristic behavior hospitals sacrifice communication and nurses feel frustrated and dissatisfied with working relationships that devalue their professional worth Read more Leave a comment Leading disengaged workers Have your managers checked out June 25th 2014 by Darlene A Cunha I recently attended a gathering with many healthcare professionals and was saddened to hear one of the participants state My managers have checked out They are doing what is minimally required and are biding time until their retirement Does this sound familiar Have you ever looked at your work schedule to see whom you would work with on any given day and then thought to yourself Tomorrow is not going to be a good day Jane Doe is working Unfortunately this phenomenon continues to plague most if not all organizations but why haven t we been able to get it right Read more Leave a comment Become an influential healthcare leader May 22nd 2014 by Darlene A Cunha Time magazine recently published the 2014 list of the 100 most influential people in the world After I read the magazine cover to cover I asked myself did I possess what it takes to be a key person of influence The truth is you probably already posses many of the traits for which people of influence are known Many key business leaders will tell you there

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=Darlene%20Cunha&page=1&disp=posts&paged=2 (2016-02-10)
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  • Hospital Impact - What hospitals can do to curb adverse events, preventable harm
    post operative events 2 Bundles that include checklists to prevent central line associated bloodstream infections 3 Interventions to reduce urinary catheter use including catheter reminders stop orders or nurse initiated removal protocols 4 Bundles that include head of bed elevation sedation vacations oral care with chlorhexidine and subglottic suctioning endotracheal tubes to prevent ventilator associated pneumonia 5 Hand hygiene 6 Do Not Use list for hazardous abbreviations 7 Multicomponent interventions to reduce pressure ulcers 8 Barrier precautions to prevent healthcare associated infections 9 Use of real time ultrasounds for central line placement 10 Interventions to improve prophylaxis for venous thromboembolisms 11 Multi component interventions to reduce falls 12 Use of clinical pharmacists to reduce adverse drug events 13 Documentation of patient preferences for life sustaining treatment 14 Obtaining informed consent to improve patients understanding of the potential risks of procedures 15 Team training and Use of simulation exercises in patient safety efforts Are there practical examples of change Most efforts to reduce harms within an organization require leadership to spearhead changes in system design including possible reorganization of resources by top level management A great example of this is Nathan Littauer Hospital in Gloversville New York which changed the way it reported information to the board of trustees on quality and safety to make the reports more clear and concise With continued improvements in reporting the board was able to execute systematic changes that lowered the health system s harm rate significantly While errors in medication surgery and diagnosis are the easiest harms to catch and detect medical errors are just as frequently the result of problems with the organization of healthcare delivery and the way that resources are provided to the delivery system In order to have a lasting effect strategies and tactics to reduce harm have to be specific to the problem and targeted for a desired result These strategic programs build upon each other magnifying impact and creating a culture of safety and accountability system wide Little Company of Mary Hospital in Evergreen Park Illinois created just such a culture and was awarded with a coveted Truven Health Everest Award for its successful launch of several improvement initiatives including one very successful effort to prevent catheter associated urinary tract infections via a nurse led campaign to reduce catheter use Moving forward Everyone wants patients to have the best possible outcomes but reducing adverse events leadership and strategy As an administrator and executive you must know and understand your hospital s bottom line in patient safety and have good tracking and reporting systems in place to institute change Continual improvement in how we use these systems will contribute to more sophisticated data outputs This coupled with transparency will create opportunities to improve patient safety and ultimately affect the bottom line of health systems Sophia Bernazzani is the community manager for MHA GW the online master of health administration from the Milken Institute School of Public Health at the George Washington University Leave a comment Please enable JavaScript to

    Original URL path: http://www.hospitalimpact.org/index.php/2015/11/24/what_hospitals_can_do_to_curb_adverse_ev (2016-02-10)
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  • Hospital Impact - RSNA 2015: Is this the year that radiology turns the corner?
    These advances are an absolute necessity for our field to continue to thrive in healthcare s future But they come at tremendous cost and often result in only small incremental improvements over technology that is already ubiquitously available The excitement surrounding these Star Trek like innovations deems them worth the dollars or so it seems These exciting scientific imaging based applications pave the way for academic careers and receive extensive attention at national meetings They are the driving force behind journal articles entitled A single institution s initial experience with Technology X or Intermediate results in patients treated with Technology Y or my favorite Pilot study of Technology Z to evaluate feasibility and efficacy of implementation Read the full commentary at FierceHealthIT Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks to limit stressors for autistic patients Nurses hospital groups clash on Massachusetts bill to improve response to violence Superbug linked scopes Feds failed to act on earlier outbreak 8 developing healthcare trends Hottest Products Compare Top Solutions in Hospital Management Electronic Medical Billing Software Healthcare Revenue Cycle Management Practice Management Software Clinical Information Systems CIS Clinical Data Repository Software CDR Medical Billing And Coding Medical Transcription Services Healthcare EDI Systems Evaluate more than 4 000 products Healthcare Finance news The shifting role of the healthcare

    Original URL path: http://www.hospitalimpact.org/index.php/2015/11/24/rsna_2015_is_this_the_year_that_radiolog (2016-02-10)
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  • Hospital Impact - What UnitedHealth is doing to tackle low health literacy
    healthcare system for everyone The recently observed International Health Literacy Awareness Month reminded us that poor health literacy doesn t only affect consumers it touches the entire health community including physicians nurses pharmacists hospitals and clinics health plans and government health programs Without information that makes sense to them people often have difficulty accessing high quality safe cost effective healthcare At UnitedHealth Group we re taking action to improve health literacy nationwide We ve created tools and programs to help consumers at every stage of life better understand their health more easily navigate their health benefits and adhere to treatments prescribed by their care providers We focus on using tools to help empower consumers employers and payers better understand health information These include UnitedHealth Group s Just Plain Clear English Spanish Glossary Taking into account the diversity of the U S and the lower health literacy in Hispanic communities it features an online glossary that makes key health terms easier to understand for both English and Spanish speakers Our results have demonstrated the high demand for such literacy tools When first launched in 2013 the glossary website had 8 100 unique visitors That number grew to 22 600 in 2014 and ballooned to more than 50 000 visitors from 73 countries so far in 2015 Consumers are receptive to the clear language used in the glossary The glossary helps individuals understand healthcare terms and also empowers them to use this information to make better health decisions for themselves and their families Making health care jargon simple and clear is an important step toward removing barriers to accessing healthcare which ultimately leads to better health Math is another key component of health literacy as it helps individuals understand the eventual out of pocket costs of care Among the more economically developed nations the United States ranks third from the bottom of 24 countries when it comes to numerical literacy according to data from the Organization for Economic Cooperation and Development UnitedHealth Group addresses this issue with online and mobile resources that enable all consumers to comparison shop for medical services Health4Me for example provides access to quality and cost information for more than 750 common medical services This mobile application is available at no charge on iPhone and Android devices A UnitedHealthcare study found that consumers using these resources are more likely than nonusers to select high quality healthcare providers Their selections included all specialties including primary care 7 percent more likely and orthopedics 9 percent more likely In addition users of these resources who looked up their costs before receiving treatment paid 30 percent less on average than non users From using less jargon and shorter sentences to providing information on cost and quality we take consumers from comprehension to action to help them take greater control of their health Consumers and healthcare professionals should challenge themselves to think about and improve their own health literacy Only by working together to improve how we communicate about health will Americans be

    Original URL path: http://www.hospitalimpact.org/index.php/2015/11/19/title_146 (2016-02-10)
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