Pharmacist-Initiated Prior Authorization Process to Improve Patient Care in a Psychiatric Acute Care Hospital

2014 ◽  
Vol 28 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Shari N. Allen ◽  
Mebanga Ojong-Salako
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Acute Care ◽  
Health Care Professionals ◽  
Care Facility ◽  
Improve Patient Care ◽  
Care Hospital ◽  
Prior Authorization ◽  
Care Plans ◽  
Effective Manner

A prior authorization (PA) is a requirement implemented by managed care organizations to help provide medications to consumers in a cost-effective manner. The PA process may be seen as a barrier by prescribers, pharmacists, pharmaceutical companies, and consumers. The lack of a standardized PA process, implemented prior to a patient’s discharge from a health care facility, may increase nonadherence to inpatient prescribed medications. Pharmacists and other health care professionals can implement a PA process specific to their institution. This article describes a pharmacist-initiated PA process implemented at an acute care psychiatric hospital. This process was initiated secondary to a need for a standardized process at the facility. To date, the process has been seen as a valuable aspect to patient care. Plans to expand this process include collecting data with regards to adherence and readmissions as well as applying for a grant to help develop a program to automate the PA program at this facility.

scholarly journals In-Home Telerehabilitation for Post-Knee Arthroplasty: A Pilot Study

2009 ◽  
Vol 1 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michel Tousignant ◽  
Patrick Boissy ◽  
Hélène Corriveau ◽  
Hélène Moffet ◽  
François Cabana
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Acute Care ◽  
Knee Arthroplasty ◽  
Health Care Professionals ◽  
Acute Care Hospital ◽  
Rehabilitation Services ◽  
Control Group ◽  
Care Hospital ◽  
Post Discharge

The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient’s home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.Keywords: Telerehabilitation, Physical Therapy, Total Knee Arthroplasty, Videoconferencing

scholarly journals A Web- and App-Based Connected Care Solution for COVID-19 In- and Outpatient Care: Qualitative Study and Application Development (Preprint)

2020 ◽  
Author(s):  
Timo Schinköthe ◽  
Mariano Rolando Gabri ◽  
Manfred Mitterer ◽  
Pedro Gouveia ◽  
Volker Heinemann ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Outpatient Care ◽  
Digital Health ◽  
Improve Patient Care ◽  
The United States ◽  
Application Development ◽  
Absolute Minimum ◽  
First Choice

BACKGROUND From the perspective of health care professionals, coronavirus disease (COVID-19) brings many challenges as well as opportunities for digital health care. One challenge is that health care professionals are at high risk of infection themselves. Therefore, in-person visits need to be reduced to an absolute minimum. Connected care solutions, including telehealth, remote patient monitoring, and secure communications between clinicians and their patients, may rapidly become the first choice in such public health emergencies. OBJECTIVE The aim of the COVID-19 Caregiver Cockpit (C19CC) was to implement a free-of-charge, web- and app-based tool for patient assessment to assist health care professionals working in the COVID-19 environment. METHODS Physicians in Argentina, Germany, Iran, Italy, Portugal, Switzerland, and the United States explained their challenges with COVID-19 patient care through unstructured interviews. Based on the collected feedback, the first version of the C19CC was built. In the second round of interviews, the application was presented to physicians, and more feedback was obtained. RESULTS Physicians identified a number of different scenarios where telemedicine or connected care solutions could rapidly improve patient care. These scenarios included outpatient care, discharge management, remote tracking of patients with chronic diseases, as well as incorporating infected physicians under quarantine into telehealth services. CONCLUSIONS The C19CC is the result of an agile and iterative development process that complements the work of physicians. It aims to improve the care and safety of people who are infected by COVID-19.

Using a geographic and interdisciplinary strategy to improve patient care outcomes.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 78-78
Author(s):  
Tony Philip ◽  
Corey Karlin-Zysman ◽  
Alex Rimar ◽  
Tara Liberman ◽  
Donna Cardoza ◽  
...  
Keyword(s):  
Palliative Care ◽  
Patient Care ◽  
Improve Patient Care ◽  
Care Hospital ◽  
Care Model ◽  
Patient Acuity ◽  
Care Plans ◽  
Oncology Care ◽  
Island Jewish Medical ◽  
Improve Patient

78 Background: Long Island Jewish Medical Center at Northwell Health is an urban/suburban academic tertiary care hospital located across the street from the Northwell Health Cancer Institute. The Division of Hospital Medicine partnered with Hematology/Oncology and Palliative Care to co-manage inpatient oncology patients on a geographic unit. The goal was to improve patient care through co-ownership and co-accountability of cancer patients in conjunction with a unit-based collaboration with Nursing, Pharmacy, Social Work, Case Management and Physical Therapy. Methods: A unit-based, interdisciplinary care team was formed consisting of Medical Oncologists, Hospitalists, Palliative Care specialists, Radiation Oncologists, as well as unit based and specialty trained nurses, social workers and advanced care practitioners. The team meets Monday thru Friday during interdisciplinary rounds to collaboratively discuss the care plans of each patient. We recently added a hospital-based medical oncologist to support greater continuity and communication. Results: Since full implementation including improvements in patient cohorting, the oncology care model has resulted in a 20% reduction in Medicare readmissions, a significant reduction in CAUTIs and CLABSIs, a 50% reduction in C.diff, a decreased CMI-adjusted length of stay and an improvement in pain management HCAHP scores, despite a 10% increase in CMI. An interdisciplinary approach has also improved documentation of goals of care discussion from 6% to 40-58%, furthering the idea of providing a unified medical voice to a vulnerable population. Conclusions: The oncology care model highlights that implementing multidisciplinary rounding, co-management and population-based geography can deliver a higher quality and more efficient level of care even in the face of higher patient acuity.

The Long-Term Acute Care Hospital: A New Option for Ventilator-Dependent Individuals

1990 ◽  
Vol 1 (2) ◽  
pp. 280-288 ◽  
Author(s):  
Jennifer A. Lundberg ◽  
Mary Lou Noll
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Negative Impact ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Health Care Environment ◽  
Term Care ◽  
Care Environment ◽  
Effective Manner

Improved health care and sophisticated medical technology have improved the outcome for many people who suffer a critical illness. One group of people who have benefited are ventilator-dependent individuals (VDIs), as evidenced by the increased number of children and adults requiring long-term mechanical ventilation. Significant changes in this nation’s health care reimbursement structure have made a substantial negative impact on the availability of traditional long-term care options for these patients. In response, a new health care environment has emerged. Now available are specialty hospitals providing general hospital services, which allow for long-term acute care intervention. The Vencor Corporation has successfully established this innovative care environment in a cost-effective manner. There are currently nine Vencor hospitals specializing in providing long-term acute care to VDIs and other catastrophically ill patients

scholarly journals A Web- and App-Based Connected Care Solution for COVID-19 In- and Outpatient Care: Qualitative Study and Application Development

10.2196/19033 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19033 ◽  
Author(s):  
Timo Schinköthe ◽  
Mariano Rolando Gabri ◽  
Manfred Mitterer ◽  
Pedro Gouveia ◽  
Volker Heinemann ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Outpatient Care ◽  
Digital Health ◽  
Improve Patient Care ◽  
The United States ◽  
Application Development ◽  
Absolute Minimum ◽  
First Choice

Background From the perspective of health care professionals, coronavirus disease (COVID-19) brings many challenges as well as opportunities for digital health care. One challenge is that health care professionals are at high risk of infection themselves. Therefore, in-person visits need to be reduced to an absolute minimum. Connected care solutions, including telehealth, remote patient monitoring, and secure communications between clinicians and their patients, may rapidly become the first choice in such public health emergencies. Objective The aim of the COVID-19 Caregiver Cockpit (C19CC) was to implement a free-of-charge, web- and app-based tool for patient assessment to assist health care professionals working in the COVID-19 environment. Methods Physicians in Argentina, Germany, Iran, Italy, Portugal, Switzerland, and the United States explained their challenges with COVID-19 patient care through unstructured interviews. Based on the collected feedback, the first version of the C19CC was built. In the second round of interviews, the application was presented to physicians, and more feedback was obtained. Results Physicians identified a number of different scenarios where telemedicine or connected care solutions could rapidly improve patient care. These scenarios included outpatient care, discharge management, remote tracking of patients with chronic diseases, as well as incorporating infected physicians under quarantine into telehealth services. Conclusions The C19CC is the result of an agile and iterative development process that complements the work of physicians. It aims to improve the care and safety of people who are infected by COVID-19.

scholarly journals Language Used by Health Care Professionals to Describe Dying at an Acute Care Hospital

2018 ◽  
Vol 56 (3) ◽  
pp. 337-343 ◽  
Author(s):  
Kirsten Wentlandt ◽  
Philippe Toupin ◽  
Natalia Novosedlik ◽  
Lisa W. Le ◽  
Camilla Zimmermann ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Care ◽  
Health Care Professionals ◽  
Acute Care Hospital ◽  
Care Hospital

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes

2021 ◽  
Vol 18 (11) ◽  
pp. 5973
Author(s):  
Tinne Dilles ◽  
Jana Heczkova ◽  
Styliani Tziaferi ◽  
Ann Karin Helgesen ◽  
Vigdis Abrahamsen Grøndahl ◽  
...  
Keyword(s):  
Health Care ◽  
Pharmaceutical Care ◽  
Health Care Professionals ◽  
Interprofessional Collaboration ◽  
Improve Patient Care ◽  
Modern Medicine ◽  
Care Quality ◽  
Practice Research ◽  
Evidence Based ◽  
Research Education

Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.

Evaluation of Ceiling Lifts in Health Care Settings

AAOHN Journal ◽  
2009 ◽  
Vol 57 (9) ◽  
pp. 374-380 ◽  
Author(s):  
Hasanat Alamgir ◽  
Olivia Wei Li ◽  
Erin Gorman ◽  
Catherine Fast ◽  
Shicheng Yu ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Pressure Ulcer ◽  
Care Facility ◽  
Care Quality ◽  
Patient Perceptions ◽  
Term Care ◽  
Health Care Settings ◽  
The Relationship

Ceiling lifts have been introduced into health care settings to reduce manual patient lifting and thus occupational injuries. Although growing evidence supports the effectiveness of ceiling lifts, a paucity of research links indicators, such as quality of patient care or patient perceptions, to the use of these transfer devices. This study explored the relationship between ceiling lift coverage rates and measures of patient care quality (e.g., incidence of facility-acquired pressure ulcers, falls, urinary infections, urinary incontinence, and assaults [patient to staff] in acute and long-term care facilities), as well as patient perceptions of satisfaction with care received while using ceiling lifts in a complex care facility. Qualitative semi-structured interviews were used to generate data. A significant inverse relationship was found between pressure ulcer rates and ceiling lift coverage; however, this effect was attenuated by year. No significant relationships existed between ceiling lift coverage and patient outcome indicators after adding the “year” variable to the model. Patients generally approved of the use of ceiling lifts and recognized many of the benefits. Ceiling lifts are not detrimental to the quality of care received by patients, and patients prefer being transferred by ceiling lifts. The relationship between ceiling lift coverage and pressure ulcer rates warrants further investigation.

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