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  • health care spending – MediCaring.org
    Sep 24 2012 I was talking about the long term effects my father s chemotherapy and radiation were taking on him to be sure the treatments had probably given him as yet uncounted years of life but they have come at a price My girlfriend who had cared for both of her parents during their struggles with cancer agreed The burdens and costs of treatments were greater than patients often understood And she told me she and her husband had developed an entirely different sort of treatment plan When their time came she said they were going to broach their health insurance plans with a deal They would forego 100 000 in treatments for a one time payout of 50 000 And check in hand they would ride off into the sunset on their ultrafast street production motorcycles wind in their faces sun at their backs Dream on I told her But after watching a pre release version of Money and Medicine a new documentary by Roger Weisberg my girlfriend s preferences seem almost worth thinking about The program which will premiere Tuesday September 25 at 8 p m ET on PBS stations nationwide talks honestly about the incentive of profit in health care while juxtaposing the actual financial costs of various treatments and procedures with the profound and troubling human costs of undergoing those treatments Watch a trailer here http www youtube com watch v a9oEtRwoVxs It follows several patients being cared for by the vastly different systems available to them at the University of California Los Angeles Medical System and at Intermountain Health Care based in Utah There are heart wrenching scenes in the UCLA ICU where we watch a young African American man convinced his comatose mother will one day recover as he struggles to understand the hospital having decided that it would be futile to try resuscitation if and when her heart stopped The hospital was continuing all other support keeping her in a limbo of unresponsive survival I call it a medical execution he says as he explains that the hospital will offer his mother comfort measures only The mother who has been in the ICU for 10 months has run up millions of dollars in costs to Medicare there is no indication that she could ever recover The son devoted and loving spends hours with her showing her old photos and talking to her Another poignant scene again an African American family shows the desperate family gathered around the patient s bedside the husband father is tethered to life support Although an ICU physician has explained in clinical terms that the patient is never likely to return to any semblance of fulfilling life the family is determined at first that he undergo any and all possible procedures His wife sobs Life is so unfair This family eventually acquiesces in the clinical team s plan to deal with any symptoms but to accept stopping treatment and allowing the dying that is in store The film

    Original URL path: http://medicaring.org/tag/health-care-spending/ (2016-04-30)
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  • Keeping Track of Dementia Patients: Would a Universal Identifier Help? – MediCaring.org
    her daily three mile walk I had to laugh just to keep my frustrations from being expose then I told him about her dementia and that she had never walked three miles daily Last spring I mentioned we had taken an occasional walk in the park His jaw almost dropped Oh was all he could say I informed him that I had told absolutely every person with whom we had come into contact that she had dementia and that I had asked each one to label her chart DEMENTIA I really wondered why he had not been told but he treaded lightly and quickly changed the subject I decided to speak to the hospital patient advocate and simply told her the situation and then I said You put a bright red armband on FALL RISK patients You clearly identify those who have drug allergies don t you She said that they did I suggested then that perhaps the hospital could do something similar to identify dementia patients perhaps to giving them a purple wristband that would identify them and note that they presented safety risks unreliable information and so on Has anyone ever considered such a universal identification system for patients living with dementia It seems to be a real safety issue for them and for their caregivers I m curious to know whether other MediCaring readers have had similar experiences and what they make of my suggestion You can contact Maryann Ingram in care of medicaring at email protected Ms Ingram an LPN with 20 years of experience in long term care is serving her second term as an appointed member of the Maryland Board of Nursing key words dementia Alzheimer s disease long term care Tweet Pin It Leave a Reply Cancel reply Your Comment You may use

    Original URL path: http://medicaring.org/2012/11/19/keeping-track-of-dementia-patients-would-a-universal-identifier-help/ (2016-04-30)
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  • IHI Expedition Launches to Improve Care for Frail Elders – MediCaring.org
    Leave a Reply Cancel reply Your Comment You may use these HTML tags and attributes a href title abbr title acronym title b blockquote cite cite code del datetime em i q cite s strike strong Name required E mail required URI Advanced Old Age Roundtable Video Online MediCaring is a service of the Center for Elder Care and Advanced Illness at Altarum Institute Follow Us To receive our email newsletter send a request to email protected Tweets by medicaring Care Transitions News Ringling Bros circus elephants set for final act Sunday USA TODAY April 29 2016 PMH announces Annette Schnabel as president CEO Bureau County Republican April 29 2016 College baseball Weekend Preview April 29 May 1 NCAA com April 29 2016 AbbVie Doubles Down on M A Bloomberg April 29 2016 Aspen Valley Hospital reaps awards for patient experience Aspen Times April 29 2016 Optimizing care transitions the role of the community pharmacist Dove Medical Press April 26 2016 3 lessons to improve patient care transitions FierceHealthcare April 21 2016 Dave Alfano Launches Caring Transitions of Central Connecticut PR Web press release April 19 2016 Older adults with dementia face increased mortality risk due to care transitions Bel

    Original URL path: http://medicaring.org/2013/09/30/ihi-expedition-launches-to-improve-care-for-frail-elders/ (2016-04-30)
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  • aged people – MediCaring.org
    insights from Andrea Kabcenell this interview offers useful information Key words IHI frail elders aged aging health care quality improvement MediCaring is a service of the Center for Elder Care and Advanced Illness at Altarum Institute Follow Us To receive our email newsletter send a request to email protected Tweets by medicaring Care Transitions News Ringling Bros circus elephants set for final act Sunday USA TODAY April 29 2016 PMH announces Annette Schnabel as president CEO Bureau County Republican April 29 2016 College baseball Weekend Preview April 29 May 1 NCAA com April 29 2016 AbbVie Doubles Down on M A Bloomberg April 29 2016 Aspen Valley Hospital reaps awards for patient experience Aspen Times April 29 2016 Optimizing care transitions the role of the community pharmacist Dove Medical Press April 26 2016 3 lessons to improve patient care transitions FierceHealthcare April 21 2016 Dave Alfano Launches Caring Transitions of Central Connecticut PR Web press release April 19 2016 Older adults with dementia face increased mortality risk due to care transitions Bel Marra Health April 14 2016 Central Wyoming Caring Transitions Owners Recognized for Pioneer Spirit PR Web press release April 4 2016 Tags advance care planning Affordable Care Act

    Original URL path: http://medicaring.org/tag/aged-people/ (2016-04-30)
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  • IHI – MediCaring.org
    Responses Tagged with care transitions hospital readmissions IHI quality improvement Nov 20 2012 by Meghan Hendricksen Anew WIHI Webinar Reality Knocks with Reducing Hospital Readmissions features Patricia Rutherford RN MS Vice President Institute for Healthcare Improvement and Leora Horwitz MD MHS Assistant Professor Internal Medicine Yale University School of Medicine two prominent women in public health They discuss the issues we face when trying to reduce hospital readmissions and the ways we can successfully accomplish this Everyone seems to agree that this isn t the time or place for any one approach instead multiple facets of different interventions need to come together to work as a whole if they are to be efficient The hour long discussion highlights the challenges and praises work that has shown to reduce 30 day readmissions so far You can listen to the broadcast here http www ihi org knowledge Pages AudioandVideo WIHIRealityKnocksReducingHospitalReadmissions aspx Key words IHI readmissions care transitions MediCaring is a service of the Center for Elder Care and Advanced Illness at Altarum Institute Follow Us To receive our email newsletter send a request to email protected Tweets by medicaring Care Transitions News Ringling Bros circus elephants set for final act Sunday USA TODAY April 29 2016 PMH announces Annette Schnabel as president CEO Bureau County Republican April 29 2016 College baseball Weekend Preview April 29 May 1 NCAA com April 29 2016 AbbVie Doubles Down on M A Bloomberg April 29 2016 Aspen Valley Hospital reaps awards for patient experience Aspen Times April 29 2016 Optimizing care transitions the role of the community pharmacist Dove Medical Press April 26 2016 3 lessons to improve patient care transitions FierceHealthcare April 21 2016 Dave Alfano Launches Caring Transitions of Central Connecticut PR Web press release April 19 2016 Older adults with dementia face increased

    Original URL path: http://medicaring.org/tag/ihi/ (2016-04-30)
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  • quality improvement – Page 2 – MediCaring.org
    challenges and stories key words frail elders readmissions IHI Commonwealth Fund Joanne Lynn STAAR QIO Care Transitions in JAMA Posted by Les Morgan on February 25 2013 No Responses Tagged with care transitions quality improvement video Feb 25 2013 Here is a video covering CMS s QIO Projects to improve care transitions in fourteen communities The study described reports on findings published in the January 23 2013 issue of JAMA This video is part of of Altarum Institute s YouTube series Great Ideas Wanted Academy for Healthcare Improvement Wants to Hear From You Posted by Janice Lynch Schuster on February 14 2013 No Responses Tagged with Academy for Health Improvement health services research quality improvement Feb 14 2013 Last year Medicaring staff participated in the first annual conference of the new Academy for Health Improvement AHI The group has a call out for abstracts for this year s event Doing Research at the Front Line of Improving Healthcare The conference runs April 25 26 2013 at the Renaissance Arlington Capital View Hotel in Arlington VA Organizers report that conference specific aims are to provide learning about research designs and methodologic approaches for healthcare delivery system interventions that can be applied in real world practice settings to provide methods of measurement of health and healthcare quality cost and value focusing on data that are relevant to patients and actionable by clinicians patients and researchers to disseminate robust methods of evaluating the success of QI research interventions to provide robust methods of learning from and disseminating QI research results to provide ways to enhance the scholarly foundation and funding policies of QI research to further increase the credibility of the science Conference activities will include varied methods of learning such as keynote lectures workshops panel discussions abstract and poster presentations and research consultations Panel discussions will occur with journal editors and funding agencies of QI research The conference targets researchers interested in integrating traditional health services research with rigorous QI science and QI research in settings that feature strong partnerships between multidisciplinary researchers and frontline providers who use QI science to improve care To register for the conference https www degnon org secure ahi meeting To submit an abstract http www a4hi org absspring index cfm page Inst Have a look and see what you might share with colleagues Key words quality improvement Academy for Health Improvement health services research QI IHI Broadcast on Reducing Readmissions Posted by Janice Lynch Schuster on November 20 2012 No Responses Tagged with care transitions hospital readmissions IHI quality improvement Nov 20 2012 by Meghan Hendricksen Anew WIHI Webinar Reality Knocks with Reducing Hospital Readmissions features Patricia Rutherford RN MS Vice President Institute for Healthcare Improvement and Leora Horwitz MD MHS Assistant Professor Internal Medicine Yale University School of Medicine two prominent women in public health They discuss the issues we face when trying to reduce hospital readmissions and the ways we can successfully accomplish this Everyone seems to agree that this isn t the time or place for any one approach instead multiple facets of different interventions need to come together to work as a whole if they are to be efficient The hour long discussion highlights the challenges and praises work that has shown to reduce 30 day readmissions so far You can listen to the broadcast here http www ihi org knowledge Pages AudioandVideo WIHIRealityKnocksReducingHospitalReadmissions aspx Key words IHI readmissions care transitions Do Awards Matter Hastings Center Cuniff Dixon Physician Awards Make a Difference Posted by Janice Lynch Schuster on July 25 2012 No Responses Tagged with eldercare end of iife care nominations physician awards quality improvement Jul 25 2012 by Bebe Guill I have mixed feelings about awards I often think they don t really matter especially in cases where as in many elementary school events these days everybody gets one Awards programs often seem ubiquitous self serving and ultimately meaningless Sometimes however I think awards matter too much I ve been second third runner up in piano competitions in foot races in writing contests and even bottom of the heap in grants competitions with accompanying scathing critique often enough to know the unique sting of also ran Awards can encourage individual competition instead of much needed collaboration Prizes can create a culture of exclusion rather than inclusion After all each time a single person is recognized it means that countless other worthy individuals and their worthy ideas and actions are neither recognized nor especially encouraged But lately I ve been convinced that awards really can matter I believe this because my friend Andy Baxter founder of the Cunniff Dixon Foundation keeps proving it with annual cash prizes recognizing good doctoring for patients at end of life Created in 2005 in memory of Carley Cunniff and in recognition of Carley s physician Peter S Dixon MD the Foundation s annual awards program recognizes that the experience that Carley and her husband my friend Andy Baxter had at the end of Carley s life a peaceful death at home with her family and loved ones is one that occurs all too rarely Determined to inspire and foster physician skills and virtues necessary to provide good end of life care more broadly Baxter s Foundation created an awards program In collaboration with The Hastings Center the Foundation provides substantial financial prizes to those physicians young and old who have shown their care of patients to be exemplary a model of good medicine and a benefit in advancing the centrality of end of life care as a basic part of the doctor patient relationship To date awards totaling 285 000 have been presented to senior mid career and early career physicians And as Baxter wrote while on a plane back to New York after presenting 2012 awards to mid career winner Dr Michael Rabow in San Francisco and to early career winner Dr Jason Morrow in San Antonio The impact of these awards is simply going way beyond anything I think any of us envisioned

    Original URL path: http://medicaring.org/tag/quality-improvement/page/2/ (2016-04-30)
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  • Comments on Payment for Advance Care Planning – MediCaring.org
    doctor on the pretext of the sacredness of life of an unborn fetus some states even extending legal personhood status to a zygote only a few moments after the possible fertilization of an egg while from the very nanosecond of birth and throughout it s entire lifetime there is no further concern for that person s physical or mental health happiness well being or anything else Funding for prenatal care neonatal care childhood nutrition 1 in 4 American children don t have enough to eat a national disgrace in such a wealthy nation childcare preschool public schools and colleges has been and continues to be ruthlessly slashed Medicaid is a perennial target for cuts and hate rhetoric the lazy the poor the illegals are wasting the tax dollars of the self righteous and hard working Medicare has barely survived the chopping block our new Speaker of the House Paul Ryan has repeatedly placed it on for almost a decade several times but that s unlikely to happen again given the complexion of the current Congress the increasingly hostile political climate and the moneyed elite and corporations behind the upcoming elections Already Speaker Ryan is resurrecting his odious plan to eliminate Medicare and replace it with block grants to states that would distribute less than a couple hundred dollars to current Medicare recipients which would purportedly allow them to purchase health insurance on the open market with the ACA s repeal it s extremely unlikely the disabled elderly could ever hope to afford even the worst health insurance especially on a fixed income without any COLA and the runaway inflation of health care costs once there are no longer any controls in place Meanwhile the disabled barely regained the 20 of their already meager EARNED SSDI income which had been arbitrarily cut by Congress as its first official act upon taking office this past January after gaining control of both Houses with today s vote on the budget extension Unfortunately the Older Americans Act was allowed to expire without a vote to extend it leaving millions of elderly and infirm citizens without adequate food or the assistance they had enjoyed for many years thanks to the Act Sadly however funding for this Act like virtually every other program intended to benefit any vulnerable population in this country had been regularly cut over and over resulting in a lengthy wait list for the vital services it provided which is certain to become even longer now Keep in mind that so far I ve been discussing programs benefitting the LIVING If this is all that s being done and grudgingly at best for people during their lifetimes is it any wonder that no one is willing to look at how we approach them in their later years and as they prepare for their last days on this Earth If this country spent just half or even one fourth of the money it devotes to waging war and dealing death on caring for PEOPLE

    Original URL path: http://medicaring.org/2015/08/25/comments-on-payment-for-advance-care-planning/?pfstyle=wp (2016-04-30)
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  • Sixth White House Conference on Aging: Now It’s Time to Do More. A Lot More. – MediCaring.org
    or misappropriation of resident property Nursing homes will have to provide training in dementia management and resident abuse prevention training to all nurse aides http www cms handinhandtoolkit info and must promulgate clear standards for ongoing quality assurance and for establishing compliance and ethics programs designed to curb fraud The regulation further proposes to require facilities to conduct thorough competency based assessments of staffing adequacy and training in order to make thoughtful informed staffing plans and decisions that are focused on meeting resident needs including maintaining or improving resident function and quality of life When combined with adequate enforcement and the forthcoming requirements for mandatory reporting of staffing based on payroll data which will include information on staffing levels type of staff tenure and turnover this requirement could provide far more accurate and comprehensive information about what arrangements work best for varying resident populations and how these correlate with the results of health and safety inspections and quality outcomes http www cms gov Medicare Quality Initiatives Patient Assessment Instruments NursingHomeQualityInits Staffing Data Submission PBJ html President Obama and other speakers called for the reauthorization of the OAA which subsequently cleared the Senate on July 16 by unanimous consent https www congress gov bill 114th congress senate bill 192 q 7B 22search 22 3A 5B 22 5C 22s192 5C 22 22 5D 7D The law expired in 2011 and has languished in Congress for 4 years struggling to amass sufficient political support In the House of Representatives the OAA has not yet been marked up which falls within the jurisdiction of the Education and Workforce Committee While it is encouraging that a reauthorization of the OAA is moving forward the statute has not been retooled to meet the needs of millions more seniors in the 21st century possibly because doing so might require allocation of more resources By virtually any measures the law is seriously underfunded to meet on the ground needs of elders who have both chronic conditions and functional limitations For example in a growing number of cities and regions around the country access to home delivered meals is nonexistent http www mealsonwheelsamerica org theissue facts resources more than a meal In an era when tens of millions of aging boomers intend to age in place in their own homes and communities the basic long term social services and supports that they will need have gone missing services like subsidized transportation household management and personal care assistance with nutrition and access to medical services benefit programs and other fundamentals of daily life During the national conference no panel squarely addressed the glaring lack of a plan to address these gaps though there was much discussion of this topic during the regional seminars and other events leading up to the WHCOA This may be because there is as yet no political or policy consensus on how to proceed Meanwhile a recent research brief prepared by the HHS Assistant Secretary for Planning and Evaluation Long Term Services and Supports for Older

    Original URL path: http://medicaring.org/2015/07/27/sixth-white-house-conference-on-aging-now-its-time-to-do-more-a-lot-more/?pfstyle=wp (2016-04-30)
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