Bold Voices - June 2014 - (Page 11)

AT THE BEDSIDE Care Transition Programs Reduce Readmissions, Penalties One hospital's care transition program includes wellness coaches who clarify confusing medication instructions at patients' homes. Services program last year, with 18 hospitals receiving the maximum penalty for excessive readmissions. Providers are concerned that these penalties will hit safety-net hospital such as Swedish Covenant the hardest, adds a related article in FierceHealthcare, "and a research letter last January backed this up, projecting that 44 percent of safetynet hospitals will be affected by the penalties, compared to only 30 percent of other hospitals." 'I Am a Patient - and I Need to Be Heard' The plight of Morgan Gleason, a 15-year-old who contracted aseptic meningitis while receiving an infusion for an autoimmune condition, indicates patient-centered care is lacking in hospitals today, according to a contributor's post on Fed up with the way she was being treated, Morgan discusses the patient's point of view, which her mother, Amy Gleason, recorded on video: "I am a patient - and I need to be heard." "Patient-centered care is a Big Thing in medicine today, as new payment incentives emphasize patient satisfaction. But too often it's still a mystery," contributor Dave deBronkart adds. Unclear Relationship Between Hypothyroidism and Mild Cognitive Impairment More studies are needed, because early treatment of underlying sources can improve cognition or slow progression of MCI. M ore research is needed to determine if there is an association between hypothyroidism and mild cognitive impairment (MCI), suggests a study in JAMA Neurology. "Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons: A Population-Based Study" indicates there is no association between clinical or subclinical hypothyroidism and MCI, after adjusting for factors such as age, sex, diabetes mellitus, hypertension and coronary artery disease. However, previous findings have been conflicting. This type of research continues to be conducted, because earlier interventions in treating the underlying sources of MCI may slow its progression, if not improve cognition altogether. This randomized, cross-sectional, cohort study evaluated 1,904 patients, ages 70 to 89, who were tested for memory, attention/executive function, and visuospatial and language domains. They were then classified as cognitively normal, having MCI or having dementia. Clinical and subclinical hypothyroidism was ascertained from medical records. MCI was present in 16 percent of the patients who had normal thyroid function, 17 percent of those with clinical hypothyroidism and 18 percent of those with subclinical hypothyroidism. 11 AACN BOLD VOICES JUNE 2014 T o reduce readmissions, hospitals must be sure that patients fully understand discharge and prescription instructions, a recent article reports. "Focusing on the Patient, Not the Condition: What Hospitals Need to Know About Avoiding Medicare Readmission Penalties," in Becker's Infection Control & Clinical Quality, notes, for example, that a care transition program at Swedish Covenant Hospital, Chicago, helped reduce readmissions to 14.25 percent during the first 10 months of 2013. Faced with a 30-day Medicare readmission rate above the national average of 16 percent, the hospital implemented a care transition program focusing on the needs of individual patients. The hospital also sent wellness coaches to patients' homes to clarify confusing medication instructions. In addition to improving patient outcomes, Swedish Covenant began the care transition program as part of incentives offered through the Medicare Hospital Readmissions Reduction Program. Two-thirds of U.S. hospitals were penalized under the Centers for Medicare & Medicaid

Table of Contents for the Digital Edition of Bold Voices - June 2014

Another Angle
Pres Note Teaser
‘Take a Chance to Make a Change in Your Patients’ Lives’
New Mobile App Launched: AACN Bedside
AACN Research Grants Continue to Drive Evidence-Based Care
AACN Scholarships to Develop Training Skills and Professional Growth
Institutional Racism Can Damage Healthcare
Culture of Violence Becoming Normal
Nip Ethical Violations in the Bud
Up to Half of Prescribed Antibiotics Unnecessary, Inappropriate
Minimal Sedation, Early Mobilization May Reduce Delirium
Care Transition Programs Reduce Readmissions, Penalties
Unclear Relationship Between Hypothyroidism and Mild Cognitive Impairment
Women Have Unique Stroke Risks
Costs Increase Because of More Inpatient Constipation
Nursing-Supportive Work Environments Linked to Better Care
Smile, You’re on ReadyCam!
Automated EHR-Linked Checklist Greatly Reduces CLABSIs
Online Game Helps Students Identify, Manage Sepsis
Sepsis Detection System More Effective in Patient Diagnosis
In Our Journals
Test Can Predict Breast Cancer Outcomes
Spice It Up With Cinnamon
IHEs: Significant Cause of Preventable ED Visits
Certification Capsules
With Deep Appreciation for Your Generosity
Save the Dates for Progressive Care, Nurse Manager Fall Conferences
AACN Chapters Model Excellence
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - June 2014