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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

With the recession taxing already overburdened emergency rooms, two stories this week offer ideas for improving patient flow in the ER. The American College of Emergency Physicians (ACEP) responds to a new Press Ganey report on ER overcrowding with its own suggestions for reducing "boarding" of ER patients. Boarding occurs when hospitals Ďholdí ER patients who have been admitted to the hospital from the emergency room. The ER staff must monitor boarded patients.

Also this week, Wishard Health Services reduced monthly staff time spent on diversion of psychiatric ER patients from more than a week to just over a day via a daily system-wide conference call, which helps to balance work and patient flow across its 23 programs.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to pdonovan@hin.com.

Associate Editor:
Jessica Papay, jpapay@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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June 29, 2009
Vol. XI, No. 24

Sponsored by:
Under One Roof: Integrating Primary Care and Behavioral Healthcare in the Medical Home

This week's industry news:

  1. Daily Conference Call Improves Psychiatric EDís Care Coordination
  2. Emergency Room Triage of the Mental Health Patient: Pilot Projects in Reducing ED Diversion
  3. Moving Critical Patients to Appropriate Floors Solves ED Overcrowding
  4. Emergency Room Utilization: Developing a Team Approach to Address Overcrowding Factors That Increase Wait Time
  5. Featured Healthcare Business White Paper: Pay for Performance — Improving Quality and Efficiency of Healthcare Delivery
  6. School-Based Prevention Program Reduces Problem Behaviors in Fifth-Graders
  7. Health Coaching for Behavior Change: Motivational Interviewing Methods and Practice
  8. New Medicare Nursing Home Guidance to Include Quality of Life and Environment Requirements
  9. The Medical Home: Pathway to Patient-Centric Primary Care
  10. Physician Performance Can Be Tiered Using Measure Composites
  11. Physician Practice Transformation Toolkit: 29 Simple Ways to Succeed in Quality Care Management
  12. Featured HealthSounds Podcast: Healthcare Trends in 2009 — A Mid-Year Financial and Legislative Update
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This week's industry news

1.) Daily Conference Call Improves Psychiatric EDís Care Coordination

Julie Szempruch, associate vice president and chief nursing officer for the Midtown Mental Health Center at Wishard Health Services, describes how a daily conference call can streamline the coordination of care within a psychiatric ED.

Our daily conference call allows people across the system to call in and coordinate care. We focus the call on all patients currently utilizing acute care services, to ensure that they receive the appropriate level of care. Facilitated by our medical director, the call is limited to 30 minutes and, utilizing a bed huddle concept, includes approximately 23 of our programs across the city.

Get the full story.

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2.) Emergency Room Triage of the Mental Health Patient: Pilot Projects in Reducing ED Diversion

Emergency Room Triage of the Mental Health Patient In this special report, one industry expert explains how the community mental health center's system-wide daily conference call helps to balance work and patient flow, encourages creative problem-solving and dramatically reduces staff time spent on diversion of psychiatric ER patients to other facilities. A second expert describes a pilot program placing a psychiatric nurse in the ED, along with the impact of the program on hospital admits, discharges and resource allocation, and ED staff satisfaction and morale.

Learn more about this resource.

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3.) Moving Critical Patients to Appropriate Floors Solves ED Overcrowding

A new report from Press Ganey finds that the gridlock in EDs is caused by the lack of inpatient beds in hospitals, not patients with non-urgent medical conditions. Responding to the 2009 Pulse Report on EDs, Dr. Nick Jouriles, president of the American College of Emergency Physicians (ACEP), agrees that improving patient flow is the key to alleviating dangerous crowding.

Get the full story.

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4.) Emergency Room Utilization: Developing a Team Approach to Address Overcrowding Factors That Increase Wait Time

Emergency Room Utilization During this webinar, three industry insiders described the strategies that their organizations have implemented to improve throughput in the ER to increase efficiencies, reduce costs and improve patient outcomes and satisfaction.

Learn more about this resource.

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5.) Featured Healthcare Business White Paper: Pay for Performance — Improving Quality and Efficiency of Healthcare Delivery

This white paper examines the history of the pay-for-performance (PFP) healthcare reimbursement model, defines measures of performance, challenges for healthcare organizations planning to implement PFP systems and the implications of PFP programs for healthcare IT.

Download this complimentary white paper.

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6.) School-Based Prevention Program Reduces Problem Behaviors in Fifth-Graders

A study suggests that school-based prevention programs begun in elementary school can significantly reduce problem behaviors in students. Fifth graders who previously participated in a comprehensive interactive school prevention program for one to four years were about half as likely to engage in substance abuse, violent behavior or sexual activity as those who did not take part in the program.

Get the full story.

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7.) Health Coaching for Behavior Change: Motivational Interviewing Methods and Practice

Health Coaching for Behavior Change Integrative medicine includes the best of conventional medicine but redefines health to include the person's body, mind, spirituality and community — with a special focus on the patient-practitioner bond. In Health Coaching for Behavior Change: Motivational Interviewing Methods and Practice, a physician and a health psychologist from the field of integrative medicine affirm how training in motivational interviewing, self-management and even spirituality and healing can enrich the health coaching encounter.

Learn more about this resource.

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8.) New Medicare Nursing Home Guidance to Include Quality of Life and Environment Requirements

CMS has issued new guidance for nursing home surveyors, further defining and clarifying several important dimensions of care to help improve nursing home residentsí quality of life and environment.

Get the full story.

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9.) The Medical Home: Pathway to Patient-Centric Primary Care

The Medical Home The Medical Home: Pathway to Patient-Centric Primary Care addresses the value and challenges of medical homes from the viewpoints of organizations already trying to establish medical homes for their populations. Covered in this 40-page special report are funding and implementation hurdles, successful methods for identifying members and redesigning office practices to move toward an advanced medical home model.

Learn more about this resource.

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10.) Physician Performance Can Be Tiered Using Measure Composites

The performance of physician practices can be reliably measured by using a composite of quality measures, according to research led by Sherrie Kaplan, Ph.D., M.P.H. of the University of California at Irvine and co-authored by NCQA executive vice president Dr. Greg Pawlson. Findings published in Medical Care used data from NCQA-recognized physicians suggests that physician practices can be distributed into three levels of relative quality (high, average, low) when a cluster of measures, rather than a single measure, is used to differentiate performance.

Get the full story.

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11.) Physician Practice Transformation Toolkit: 29 Simple Ways to Succeed in Quality Care Management

Physician Practice Transformation Toolkit This 44-page special report offers tested strategies, tools and processes from physician thought leaders who have guided practices through the transformation process. Physician thought leaders who have already retooled physician practices share 29 key strategies that can set the stage for a practice that can easily participate in and profit from emerging reimbursement strategies, including PFP programs and the patient-centered medical home.

Learn more about this resource.

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12.) Featured HealthSounds Podcast: Healthcare Trends in 2009 — A Mid-Year Financial and Legislative Update

Paul Keckley Early and costly proposals for healthcare reform are creating clouds of uncertainty on the healthcare horizon, providing scant relief for organizations stymied by the economy, patient safety issues and internal budget restraints, observes Paul Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions. As he prepares a mid-year review of financial and legislative trends shaping the healthcare industry, Keckley anticipates a slow and bumpy road to EHR adoption and defines the three key elements of the platform for a new generation of care-giving and care consumption at a community level.

Listen to this podcast.

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