There are many innovative practices being used to make sure patients are not unnecessarily readmitted to the hospital.
A U.S News article describes a discharge regimen used by the Cleveland Clinic.
“When Richard Jones of Niles, Ohio, 70, was discharged in May, he was sent home with a digital scale to flag any weight fluctuations (a possible sign of fluid buildup), a blood pressure cuff, and other monitoring equipment tied into the hospital system. He was also assigned a telemonitoring support team of nurses, social workers, nutritionists, therapists, and doctors who would check his vital signs daily, remotely or in person, for up to 40 days. In phone and house calls, the team coordinated follow-up doctor visits and counseled the lifelong cheeseburger-and-fries fan on worrisome symptoms to watch for and how to make lifestyle changes stick.”
Like most everyone I know I don’t look at the EOBs (Explanation of Benefits) I get from Medicare and United Health Care. Do you?
A New York Times article noted “LIKE most people, I am generally vigilant about paying my bills — credit cards, mortgage, cellphone and so on. But medical bills have a different trajectory. I (usually) open the envelopes and peruse the amalgam of codes and charges. I sigh or swear. And set them aside for when I have time to clarify the confusion: An out-of-network charge from a doctor I know is in-network? An un-itemized laboratory bill from a doctor I’ve never heard of? A bill for a huge charge before my insurer has paid its yet unknown portion of a hospital’s unknowable fee?”
A conundrum: go to your local community hospital or an academic medical center?
An article in Becker’s Hospital Review reported on a study published in Health Affairs which “raised questions about whether hospitals’ reputations match the quality of care they provide. The study examined the differences between high-price and low-price hospitals and found the more costly providers were the clear winners in U.S. News & World Report rankings, which are partly (32.5 percent for the Best Hospitals 2013-14) based on their reputation with specialists. However, low-price hospitals performed better on certain outcomes-based readmissions and patient safety measures, such as postoperative blood clots. If high-price hospitals tend to have better reputations, the study raises the question of whether there’s a disconnect between how hospitals are perceived and how they perform and whether reputation should play a part in lists such as Truven Health Analytics’ 100 Top Hospitals, Becker’s Hospital Review’s “100 Great Hospitals” and U.S. News’ Best Hospitals.”
The New York Times reported: “Hospitals nationwide are hustling to prepare for the first traveler from West Africa who arrives in the emergency room with symptoms of infection with the Ebola virus.
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, has said such a case is inevitable in the United States, and the agency this month issued the first extensive guidelines for hospitals on how recognize and treat Ebola patients.
The recommendations touch on everything from the safe handling of lab specimens to effective isolation of suspected Ebola patients …
ABC News reported: “American hospitals and state labs have handled at least 68 Ebola scares over the last three weeks, according to the U.S. Centers for Disease Control and Prevention.
Hospitals in 27 states alerted the CDC of the possible Ebola cases out of an abundance of caution amid the growing outbreak in Guinea, Liberia and Sierra Leone. Fifty-eight cases were deemed false alarms after CDC officials spoke with medical professions about patient exposures and symptoms, but blood samples for the remaining 10 were sent to the CDC for testing, the agency told ABC News today.
The Mount Sinai Hospital has been ranked No. 16 out of nearly 5,000 hospitals nationwide in the U.S. News & World Report 2014–15 “Best Hospitals” guidebook. Additionally, New York Eye and Ear Infirmary of Mount Sinai achieved a No. 10 national ranking for Ophthalmology, while Mount Sinai Beth Israel and Mount Sinai St. Luke’s/Mount Sinai Roosevelt attained “high-performing” designations in a total of 11 specialties.
Further, according to U.S. News & World Report, The Mount Sinai Hospital is one of only 17 hospitals to receive “very high scores” in at least six clinical specialties, earning it Honor Roll status.
We all go to the doctor, the ER or are admitted to the hospital without asking what it will cost.
A New York Times article started with this vignette:
“Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician’s assistant at her dermatologist’s office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away.
In the recent past a hospitalized patient expected to see one’s primary care practitioner making rounds, examining patients and writing “orders.”
An article in Newsday addressed the question: “Do you know if your primary care physician will manage your care if you are admitted to the hospital?”
“Reflecting today’s changing medical practices, some primary care doctors don’t set foot inside their patients’ hospital rooms at all — leaving their care to physicians called hospitalists.
An article in Becker’s Hospital Review reported that hospital interns generally failed to use “five key communications strategies, including introducing themselves, explaining their role in the patient’s care, touching the patient, asking open-ended questions such as ‘How are you feeling today?’ and sitting down with the patient. The five actions are components of what is termed ‘etiquette-based medicine,’ as described in a 2008 New England Journal of Medicine article by Michael W. Kahn, MD.”
“With internal medicine in particular, especially these days, it’s about chronic medical problems and chronic care, where much of what we need to do is motivate the patient to provide self-care and self-management to improve their health over the long term … You can’t do that if you’re not connecting with the patient very well.”