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- 1. NURS 375 Ryan Plesher Zenny Page Laura Plyler Meghan Price Rosemary Ogaga
- 2. http://www.youtube.com/wat ch?v=TS6vjYgKp4Y&feat ure=em-share_video_user -CMS soon will penalize hospitals that see too many patients return within a month. -Now is the time to create strategies to avoid readmissions. -Informatics can, and potentially will, play a large role in solutions and transitions.
- 3. -Search: Reducing Hospital Readmissions with the Use of Informatics -Strengths -No Fees -User Friendly -Fast -Access to thousands of websites and scholarly journals -Weaknesses -Too many sources -Reliability and Validity -Weaknesses outweigh the strengths
- 4. -Strengths -Metasearch engine -Best, most relevant, combined results from others such as Google, Yahoo, Ask etc. -Capabilities and techniques of all the major search engines to make a super engine! -Time saver! -Fast -Refines results with “Are you looking for” feature -Weaknesses -Can sometimes have irrelevant results -Not good for specific searches
- 5. -Strengths -Searching options -Factual information -Weaknesses -Access -Readability Search Results?
- 6. -Search: Reducing Hospital Re-admissions -427 Results in 0.11 seconds -Clinical Trials -clinicaltrials.gov -National Institute of Nursing Research: www.ninr.nih.gov -Who? -Hospitals -Individuals conducting personal research -Links to Social Media
- 7. -Home healthcare -Cost efficient -Prevent readmissions -Transition from hospital to home -Comfort -Independence
- 8. http://www.loopbackllc.com/Readmission.aspx -Why should hospitals be concerned about readmission? -The Centers for Medicare and Medicaid Services (CMS) is targeting hospital readmissions for cost reductions. -One in five Medicare patients is readmitted to the hospital within 30 days of discharge, costing billions of dollars. -CMS will begin imposing financial penalties for excessive readmissions for Heart Failure, Acute Myocardial Infarction and Pneumonia beginning in October, 2012. -Hospitals in the bottom quartile on readmissions will suffer penalties in the hundreds of thousands, if not millions, of dollars.
- 9. -Focuses on reducing readmissions within 30 days of discharge through patient teaching. -Uses an interactive program to help patients—”Louise” -Louise helps make care plans -Teaches about components of patient care, their medications, etc -Who can use it? -Louise is tailored uniquely for -Hospitals each individual patient -Individual Patients -Is based on 12 reinforcing -Home Health Organizations components, which have been -Training and educating of clinical staff proven to reduce rehospitalization. -Used as trial right now but soon will be distributed to different hospitals to be evaluated and tested.
- 10. -Healthcare provider that promotes care through the use of technology -Benefits -Remote patient monitoring -Cost efficient -Quality -Prevent rehospitalization Who? -Patients that have been recently admitted and may have a possible future of further hospitalization.
- 11. -List serv sign up: http://www.hospitalmedicine.org/AM/Template.cfm?Sectio n=Home&Template=/BOOST/boost.html -What is BOOST? -Objectives -Nursing Application
- 12. -http://apps.facebook.com/my- polls/view/oyipyhga -Poll on Facebook -Facebook is a social utility that connects people with friends and others who work, study and live around them. People use Facebook to keep up with friends, upload an unlimited number of photos, post links and videos, and learn more about the people they meet. -One has to ensure that there is private security when using Facebook
- 13. -Quality control -Improving care and teaching techniques -Staying up to date on current training -Improving scope of practice during patient stay -Focus on the discharge process-- teaching, communication, etc -Using current programs and organizations to transition from hospital to home and promote -Using reallifestyles. dashboards for and healthy time and Thus monitors improved communication aids in disease prevention. -Using Listservs to be involved in current information -Websites and search engines to research topic specific articles, magazines, newspapers, etc.
- 14. -Using search engines to stay up to date on CMS and the Hospital Readmissions Reduction Program. -Improving the discharge process with enhanced patient education. -Using post-hospital programs like RED, Amedisys, Loopback Analytical, etc. -Acknowledge and discuss barriers of the discharge process and enhanced self care. -Ex: patient not having a family doctor; not owning a car to be able to go to follow up appointments -Encourage family/support interaction in post-hospital care -Discuss health maintenance and disease management and preventative measures
- 15. 6 ways to prevent hospital readmissions. (2011). Patient Education Management, 18(6), 71-72. About dogpile. (2011). Retrieved from http://www.dogpile.com/info.dogpl/support/aboutus Amedisys. (n.d.). Retrieved October 25, 2012, from http://www.amedisys.com/ Americantelemed.org. (2011). Retrieved from http://www.americantelemed.org/i4a/pages/index.cfm?pageid=3331 Ebsco host. (n.d.). Retrieved October 22, 2012, from http://ezproxy.queens.edu:2457/ehost/search/basic?sid=17ed6c83- 7679-4215-b063- ebd9a7317596@sessionmgr15&vid=7&hid=2 Facebook. (2012). Retrieved October 25, 2012, from http://facebook.com Google. (n.d.). Retrieved October 25, 2012, from www.google.com Hebda, T., & Czar, P. (2012). Handbook of Informatics for Nurses & Healthcare Professionals (5th ed.). Saddle River, NJ: Pearson. Hospital, nurses team up to prevent readmissions. (2012). Hospital Case Management, 20(9), 140-141 Look beyond your hospital walls to prevent readmissions. (2012). Hospital Case Management, 20(9), 129-131. Loopback Analytics. (2012). Retrieved October 20, 2012, from http://www.loopbackllc.com Martin, J. (2007-2012). Project red: Re-engineered discharge. Retrieved from http://www.bu.edu/fammed/projectred/index.html National Institute of Health. (n.d.). Retrieved October 23, 2012, from www.nih.edu Reducing Hospital Readmission. (2012). Retreived October 20, 2012, from http://www.youtube.com Society of hospital medicine. (n.d.). Retrieved October 26, 2012, f rom http://www.hospitalmedicine.org/AM/Template.cfm?Section=Home&Template=/BOOST/boost.html
Notas do Editor
- Founded in 1998 by Larry Page and Sergey Brin.Google’s mission: to organize the world’s information and make it universally accessible and useful.Search: Reducing hospital readmission with the use of informatics -371,000 resultsStrengths: -No fees to use Google -User Friendly: easily accessible for the user. -Results were generated in 0.20 seconds -Access to thousands of websites and scholarly journalsWeaknesses -371,000 initial results. Impossible to go through all of these results to find the best articles. May have to tweak their search. -Use search techniques specific to Google -Phrase Searching -+Requires/-Excludes -Truncation -How reliable and valid are the results that Google produced? May require the user to do extra research to determine whether this source is reliable and valid.Weaknesses outweigh the strengths. Google is a place to start but as far as conducting a search as specific as reducing hospital readmissions may be better done on a more credible search engine where professional/scholarly journals are the focus.
- -Developer by Aaron Flin in Nov 1996-received the J.D. Power and Associates award for best Residential Online Search Engine Service in both 2006and 2007.-Toolthat sends user requests to several other search engines and/or databases and aggregates the results into a single list or displays them according to their source.-Metasearch engines enable users to enter search criteria once and access several search engines simultaneously.-Saves time so we don’t have to search multiple sites individually!-Free!-Refines results by suggesting new terms based on the searched terms. Ex: search insurance, it will return home, auto, fire, boat etc. click that and you will get results from all of those keywords. Unlike yahoo or any other engine, it will just return insurance types instead of narrowing it down for finer results.-Returns many results that sometimes can be irrelevant.-The search is so broad that it may not be specific enough since it uses many other engines top results. Ex: goldfish crackers returns results of feeding goldfish crackers and bogus websites while google brings up recipes, flavors, retailers etc
- The pros: EBSCO Host provides search options to discover full text articles chosen from various databases and written within specified timeframes. The user may also choose publications types such as government, magazine, newspapers, or Journal articles and even select for only peer reviewed articles to be shown in the results. There is another option to search articles by author or ISBN numbers. The cons: EBSCO Host requires an access code. It is useful for students because many college campuses allow access to the database through the college library like Queens University does.Search Results: When Preventing hospital readmissions was searched on the EBSCO Host databases various articles and clinical trials were found including ways that Medicaid and Medicare can give hospitals penalty charges for excess readmissions and ways that nurses can find to work together to prevent readmissions. Many articles discuss how important the discharge process is and how the transition from the hospital back in the community can take time. It may not be instant. Giving patients specific information that pertains to their individual care plan and not just to a majority can also be helpful. Communication with the patient and their home health provider or their family physician is important to be sure that they are still getting adequate care even after their hospital discharge. Staff should keep an eye out for barriers to the discharge process. For example, a family might not own a car to be able to dive a family member to and from the hospital. Disease management to keep chronic diseases under control is a makes a big difference to how many times a patient will have to return to the hospital.
- -The National Institutes of Health is made up of 27 different components called Institutes and Centers. Each has its own specific research agenda. All but 3 of these components receive their funding directly from Congress and administrate their own budgets. -Trustworthy website-Results: 427 in 0.11 seconds -Fast and a more focused search -Most of these results come from clinical trials stored in government archives -Large professional associations (i.e. hospitals, universities, government, and official health organizations) tend to have the most reliable sites. -Good source of information for the consumer, since they know the NIH is a government funded site. -Hospitals can research ways to reduce their re-admissions rates. Many of these articles focus of quality control and improvement during patient stay. Also focus on the discharge process. Can also find suggestions to improve training and receiving grants and funding for higher rates of quality control/improvement. -Consumer can easily access this website from any computer (with access to Internet) and educate themselves about hospital re-admission rates. Good site for anyone in the academic or healthcare settings.-Social Media links. The NIH provides links to their various social media pages. These links enable the consumer to be up to date on the latest information. They also allow the user to post their own ideas and research about reducing hospital readmission rates.
- Amedysis is a home healthcare website that has a program called Care Transitions specifically works to transition patients back into their lifestyle at home. Care Transitions encourage independence and healthy lifestyle to promote health while teaching patients how to transition back into life at home including monitoring and disease prevention.4.88 billion in savings to medicare. Due to the enormous amount of baby boomers in USA.-Only going to get worse. 4.88 billion translates to 20% reduction in avoidable hospital readmissions by 2014, aligning with the Partnership for Patients.7% reduction in 30-day hospital readmissions, 5% reduction in hospital admissions, and2% reduction in costs in communities tackling care transitions together by July 20142% relative improvement rate decrease in 30-day readmissions and admissions statewide by July 2014
- -Telemedicine is the use of medical information is exchanged from one site to another via electronic communications to improve a patient’s clinical health status.-using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.-extending care to patients in remote areas, the use of telemedicine has spread rapidly and is now becoming integrated into the ongoing operations of hospitals, specialty departments, home health agencies, private physician offices as well as consumer’s homes and workplaces.-Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumerfocused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth.Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.Studies have consistently shown that the quality of healthcare services delivered via telemedicine are as good those given in traditional in-person consulations. In some specialties, particularly in mental health and ICU care, telemedicine delivers a superior product, with greater outcomes and patient satisfaction.Using telemedicine technologies reduces travel time and related stresses for the patient. Over the past 15 years study after study has documented patient satisfaction and support for telemedical services. Such services offer patients the access to providers that might not be available otherwise, as well as medical services without the need to travel long distances.
- Project Boost stands for Better Outcomes for Older Adults through Safe Transitions. The goal is to improve care of patients when they are discharged from the hospital and moving back into their homes. Objectives:• Identify high risk patients when they are admitted to the hospital use specific interventions to target those risks• Reduce 30 day readmission for general medicine patients• Reduce the amount of time that patients are in the hospital• Increase the level of patient satisfaction• Improve the transmission of information between inpatient and outpatient providersBOOST offers day long training session and year long coaching/mentoring programs for hospitals to help prevent readmissionsThis is applicable to the nursing practice because nurses spend a great deal of time interacting with patients in the hospital. Nurses can help to identify high risk patients to perform interventions and be sure that those patients are satisfied with their level of care. Improving information flow can be linked to our nursing informatics class and the improvement of technology. Project BOOST also suggests that Nurses complete culturally competent care, use BOOST’s discharge checklist before a patient is released from the hospital, and call patients 72 hours after discharge.
- Preventative maintenance and