Download or read book Emergency Department Cluster High Utilizers written by Luke Barrett and published by . This book was released on 2018 with total page 18 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this research was to identify demographics of people who repeatedly have multiple emergency department visits over a short period of time, defined by this project as cluster high utilizers, and to draw attention to the impact of cluster high utilizers on health care systems. This research included retrospective hospital data organized by quantity of emergency department visits per week over a four-year period. The methods for data analysis included descriptive statistics focused on demographics and emergency department utilization for a sample of cluster high utilizers (n = 53). Cluster high utilizers in this research were most likely to be middle aged, homeless, white, male, have MediCal health insurance, not have a primary care provider, and visit the emergency department in the summer months. The results of this research indicate that cluster high utilizers represent an extremely small portion of the overall emergency department patient population (0.83%); however, they use the emergency department at significantly higher rates, in this study 2,644% more than the general patient population (N = 92,313). Further research is necessary to determine the causes of cluster high utilization and to design effective social work and emergency department interventions. Addressing this problem could prevent many unnecessary emergency department visits.
Download or read book Value and Quality Innovations in Acute and Emergency Care written by Jennifer L. Wiler and published by Cambridge University Press. This book was released on 2017-03-21 with total page 251 pages. Available in PDF, EPUB and Kindle. Book excerpt: Access to acute and emergency care is essential when we are ill or injured, but the costs are significant. How can we make services more efficient and effective? This thought-provoking text provides twenty case studies detailing successful innovations to enhance value, including telehealth, observation medicine, high utilizer programs, and the use of informatics to improve clinical decision support. A detailed history of system developments over the last fifty years in the US and internationally is provided, and subjects including measurement and quality improvement, volume versus value based care, and emergency department crowding are discussed. This book is an ideal way for emergency physicians and healthcare managers to explore new ideas and enhance the quality of care in their area.
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Emergency Department written by Tina Kang-Lim and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book An Evidence Based Implementation Project on High Utilizers in the Emergency Department written by Bernadette Martin Ruggles and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract Challenges have been presented to the Emergency Department (ED) over the last several years as the dramatic rise in health insurance enrollment continues. Although, with the Republican bill, the American Health Care Act, changes to Medicaid may alter the health program leaving many uncertainties (Kaplan & Pear, 2017). Evidence reflects EDs are inundated with even more patients taking advantage of the availability of a one-stop shop for their care and treatment. Costs of ED services and resource allocation are rising as a result of these unnecessary visits contributing to a total healthcare expenditure of approximately 17.6% of the US Gross Domestic Product (GDP) (Horst, Martin, Gambler, & Coco, 2011). Various quality improvement measures have been implemented across the nation to reduce these costs such as the utilization of PreManage EDTM. The PreManage EDTM implementation pilot in Alameda County enables identification of patients frequently using ED services within a shared geographical region (Azar, Pressman, Oehmke, & Xu, 2017). This quality improvement project sought to educate the nursing staff, increasing their knowledge and awareness of PreManage EDTM, health care resources, and assisting the health care team to provide improved access for patients' non-urgent healthcare needs. Prior to the education, a pre and post survey obtained a direct correlation between assessment and knowledge as a result of the education which was reflected utilizing the Wilcoxon Signed-Ranks Test with a Z=278, p
Download or read book Data Driven Approaches for Healthcare written by Chengliang Yang and published by CRC Press. This book was released on 2019-10-01 with total page 119 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care utilization routinely generates vast amounts of data from sources ranging from electronic medical records, insurance claims, vital signs, and patient-reported outcomes. Predicting health outcomes using data modeling approaches is an emerging field that can reveal important insights into disproportionate spending patterns. This book presents data driven methods, especially machine learning, for understanding and approaching the high utilizers problem, using the example of a large public insurance program. It describes important goals for data driven approaches from different aspects of the high utilizer problem, and identifies challenges uniquely posed by this problem. Key Features: Introduces basic elements of health care data, especially for administrative claims data, including disease code, procedure codes, and drug codes Provides tailored supervised and unsupervised machine learning approaches for understanding and predicting the high utilizers Presents descriptive data driven methods for the high utilizer population Identifies a best-fitting linear and tree-based regression model to account for patients’ acute and chronic condition loads and demographic characteristics
Download or read book Data Driven Approaches for Healthcare written by Chengliang Yang and published by CRC Press. This book was released on 2019-10-01 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care utilization routinely generates vast amounts of data from sources ranging from electronic medical records, insurance claims, vital signs, and patient-reported outcomes. Predicting health outcomes using data modeling approaches is an emerging field that can reveal important insights into disproportionate spending patterns. This book presents data driven methods, especially machine learning, for understanding and approaching the high utilizers problem, using the example of a large public insurance program. It describes important goals for data driven approaches from different aspects of the high utilizer problem, and identifies challenges uniquely posed by this problem. Key Features: Introduces basic elements of health care data, especially for administrative claims data, including disease code, procedure codes, and drug codes Provides tailored supervised and unsupervised machine learning approaches for understanding and predicting the high utilizers Presents descriptive data driven methods for the high utilizer population Identifies a best-fitting linear and tree-based regression model to account for patients’ acute and chronic condition loads and demographic characteristics
Download or read book Managing Suicidal Risk written by David A. Jobes and published by Guilford Publications. This book was released on 2016-06-20 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book has been replaced by Managing Suicidal Risk, Third Edition, ISBN 978-1-4625-5269-6.
Download or read book Emergency Department Frequent Users written by Lauren E. Birmingham and published by . This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Emergency department (ED) frequent users are those patients who make four or more ED visits in a 12-month period. Their impact on healthcare costs and ED capacity is substantial. Many policies and interventions have been designed to reduce their utilization, although randomized controlled trials have not shown great improvements in utilization or healthcare expenditures. Most interventions for ED frequent users are delivered to the entire population of ED frequent users, despite a high degree of heterogeneity within the population. In this work, a targeted approach to interventions for ED frequent users is proposed. However, before targeted interventions can be developed, a typology of ED frequent users needs to be created. This work created a typology of ED frequent users using Latent Class Analysis (LCA). The result is a four-group typology consisting of a heart-related group, long-term ED frequent user group, short-term ED frequent user group, and a minor care group. The long-term group is the highest total cost group ($4.5 million in costs to the hospital) and the heart group had the highest per-person hospital costs ($5,609 per person). It is recommended that the hospital pursue interventions for both the heart group and long-term groups to create both a short-term and long-term cost avoidance strategy with respect to high utilizing emergency department patients.
Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Download or read book Hospital Management and Emergency Medicine Breakthroughs in Research and Practice written by Management Association, Information Resources and published by IGI Global. This book was released on 2020-02-07 with total page 627 pages. Available in PDF, EPUB and Kindle. Book excerpt: Improvements in hospital management and emergency medical and critical care services require continual attention and dedication to ensure efficient and proper care for citizens. To support this endeavor, professionals rely more and more on the application of information systems and technologies to promote the overall quality of modern healthcare. Implementing effective technologies and strategies ensures proper quality and instruction for both the patient and medical practitioners. Hospital Management and Emergency Medicine: Breakthroughs in Research and Practice examines the latest scholarly material on emerging strategies and methods for delivering optimal emergency medical care and examines the latest technologies and tools that support the development of efficient emergency departments and hospital staff. While highlighting the challenges medical practitioners and healthcare professionals face when treating patients and striving to optimize their processes, the book shows how revolutionary technologies and methods are vastly improving how healthcare is implemented globally. Highlighting a range of topics such as overcrowding, decision support systems, and patient safety, this publication is an ideal reference source for hospital directors, hospital staff, emergency medical services, paramedics, medical administrators, managers and employees of health units, physicians, medical students, academicians, and researchers seeking current research on providing optimal care in emergency medicine.
Download or read book Retooling for an Aging America written by Institute of Medicine and published by National Academies Press. This book was released on 2008-08-27 with total page 316 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
Download or read book Homeless High Users of the Emergency Department written by Kelsey McGuire and published by . This book was released on 2017 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Patients who frequently use Emergency Department (ED) services are particularly vulnerable to poor health outcomes and have high healthcare costs. Homeless high users have particularly complex healthcare needs and increased difficulty in using and accessing healthcare. To determine modifiable targets for intervention, understanding patient perspectives on their healthcare service use must first occur; however, patient perspectives, especially those of homeless high users, have been absent from the literature. Aim: To describe the views of homeless high users of the ED about the influence of life experiences on their ED use. Methods: Researchers conducted in-depth, semi-structured interviews with 18 homeless persons with more than four ED visits in the six months prior to interview date. Interviews were audio recorded and transcribed verbatim for analysis in Dedoose by three coders. Qualitative analysis was performed in three phases--open, axial, and selective--to illuminate final themes. Quantitative data from medical records triangulated interview data and interviewer notes. Results: In describing the pattern of use by homeless high users, four domains emerged: a (1) crisis moment leads to increased ED use, which warrants an (2) intervention that (3) stabilizes patients for a period; (4) predisposing instability impacts both whether a crisis moment will occur and the degree to which a crisis moment impacts ED use. Conclusions: This work contributes to understanding the multitude of factors that impact ED use among the most vulnerable patients, which is the first step in elucidating promising interventions. Future interventions should consider expanding evidence-based case management programs. The next research step is to standardize a set of data socioeconomic data elements to determine which patients warrant intervention immediately after a crisis point rather than after ED use has drastically increased.
Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 396 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Download or read book Resident Duty Hours written by Institute of Medicine and published by National Academies Press. This book was released on 2009-04-27 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.
Download or read book Vignettes in Patient Safety written by Michael S. Firstenberg and published by BoD – Books on Demand. This book was released on 2017-09-13 with total page 187 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is clearly recognized that medical errors represent a significant source of preventable healthcare-related morbidity and mortality. Furthermore, evidence shows that such complications are often the result of a series of smaller errors, missed opportunities, poor communication, breakdowns in established guidelines or protocols, or system-based deficiencies. While such events often start with the misadventures of an individual, it is how such events are managed that can determine outcomes and hopefully prevent future adverse events. The goal of Vignettes in Patient Safety is to illustrate and discuss, in a clinically relevant format, examples in which evidence-based approaches to patient care, using established methodologies to develop highly functional multidisciplinary teams, can help foster an institutional culture of patient safety and high-quality care delivery.
Download or read book A Case based Approach to Emergency Psychiatry written by Katherine Maloy and published by Oxford University Press. This book was released on 2016 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: Working in an emergency department as a psychiatrist or mental health clinician requires an ability to gain a patient's rapport, establish a differential diagnosis, assess risk, and make disposition decisions in a fast-paced and potentially chaotic setting. A Case-Based Approach to Emergency Psychiatry, written by psychiatrists who work daily in the emergency setting, will assist the emergency department clinician in learning these skills through vivid, complex cases that illustrate basic principles of assessment, diagnosis, and treatment.
