CMSA Today - Issue 2, 2013 - (Page 6)

President’s Letter And, Then There’s Frank! BY NANCY SKINNER, RN-BC, CCM T he delivery of health care in America is often disorganized and haphazard, with patients shuffled from one provider or one site of care to another with little advocacy, no established transitional care plan, and absolutely no idea that it should not be that way. Patients are frequently confused and lost in a system that offers medical services and interventions to them but does not consistently partner with them, their family, or support system to achieve the goals the patient seeks. As patients are moved through those systems of care, the quality of care is sometimes compromised. In 2001, 6 CMSA TODAY Issue 2 • 2013 the Institute of Medicine published a consensus report entitled Crossing the Quality Chasm: A New Health System for the 21st Century. This document offered a vision of health care delivery that promotes the consistent provision of services that are safe, timely, effective, efficient, equitable, and patientcentered. Although more than a decade has passed since the publication of that strong recommendation for change, those goals have not been fully achieved as evidenced by the following: • Health care-associated infections impact 1 out of 20 hospitalized patients each year. These potentially preventable infections are the proximate cause of nearly 99,000 deaths annually, all while generating costs of $35 billion;1 • It is estimated that medical errors are the direct cause of death for 200,000 Americans each year; • Approximately 13.5 percent of hospitalized Medicare beneficiaries experience adverse events during their hospital stays;2 • Nearly 2 million Medicare beneficiaries are readmitted within 30 days each year, costing Medicare $17.5 billion in additional hospital bills; • About $750 billion is lost each year to wasteful or excessive health care spending. This sum includes excess administrative costs, inflated prices, unnecessary services, and fraud.3 These numbers reflect a problem that touches a nameless, faceless portion of the American public. We often speak of them as Mr. Smith or the patient in Room 246, or tag them as the non-compliant or the uninvolved, uncaring patient. And, in some cases, we just push them through the system so that they become a concern at the next level of care for the next provider of services. In reality, they each have a face and they each have a story. Some of those stories have glorious endings; some have challenges with ultimate resolution; and then there’s Frank. This is Frank’s story as he tells it. It is presented to you with his support and permission. His name and circumstances have not been modified to protect his identity. It is his view of a system that he feels failed him. And, while he accepts responsibility for his occasional nonadherence to the plan, he believes he did not receive the support necessary to successfully manage his medical condition. (Please note that all statements presented in quotations marks are Frank’s words and his representation of the events he experienced.) In 1993, Frank was involved in a motor vehicle accident that resulted in a spinal cord injury at T12-L1. His initial treatment included stabilization of the spine and post-acute rehabilitation at a rehabilitation center that facilitated his return to his home and community with the tools necessary to be successful in that transition. For many years, Frank was successful in meeting the challenges of living with a spinal cord injury. In 2007, Frank faced a challenge that he could not resolve and his condition spiraled through a series of

Table of Contents for the Digital Edition of CMSA Today - Issue 2, 2013

President's Letter
Role of the Nurse Care Manager in a Patient-Centered Medical Home
Association news
View from Capitol Hill
Case Management and the Law
Ethics Casebook
Mentoring Matters
CMSA Corporate Partners
Index of Advertisers

CMSA Today - Issue 2, 2013