News Article: Briefer hospitalizations are not always best, Pennsylvania study finds

For some patients, shorter hospital stays aren't better.
A study of 15,531 Pennsylvania patients diagnosed with a pulmonary embolism - a life-threatening condition in which a blood clot blocks a vessel in the lungs - found that those discharged more quickly were at greater risk of death.
The researchers, from Pittsburgh and Switzerland, examined hospital billing data from the Pennsylvania Health Care Cost Containment Council. They found that the patients who were discharged after four or fewer days were significantly more likely to die than those who remained in the hospital for five, six or more days.
The study sought to determine whether new guidelines that recommend patients identified as being at low-risk for complications be discharged more quickly were working as intended.

TO VIEW THE REST OF THIS ARTICLE CLICK HERE: http://www.philly.com/inquirer/breaking/news_breaking/20080415_Briefer_hospitalizations_are_not_always_best__Pennsylvania_study_finds.html?adString=inq.news/news_breaking;!category=news_breaking;&randomOrd=042508101503

News Article: Exodus of specialists from ERs raises concerns

To read this article, follow this link:

http://www.latimes.com/news/local/la-me-er25apr25,0,4475836.story

Ouch!

100 degrees by Monday in Phoenix??? Help!

News Article: Healthcare Coalition Approves Tools to Improve Patient Safety

Little Rock, Ark. (April 24, 2008) — The National Transitions of Care Coalition (NTOCC) Advisory Task Force has authorized the release of recently developed tools for helping healthcare professionals and organizations address problems inherent in transitioning patients from one level of care to another. The tools represent the culmination of several months of collaboration between 29 industry stakeholders who joined together in 2006 to address challenges associated with transitions of care. In addition, NTOCC is also releasing accompanying information on how to implement and measure the tools, as well as material designed to raise industry, policy maker, media, and the general public's awareness of transitions of care. The material will be made available on NTOCC's website (www.ntocc.org/) at the end of April. NTOCC is chaired and coordinated by the Case Management Society of America (CMSA) in partnership with sanofi-aventis U.S. LLC.

"The amount of work this group has accomplished in just 18 months is impressive," Cheri Lattimer, NTOCC Project Director and CMSA Executive Director said. "For a group this large, representing such various points of view within healthcare to come together and not only agree that transitions of care is a serious problem but also design, develop and launch tools to impact this issue a fantastic accomplishment."

Included with the launch of the tools is a "Case Study Implementation and Evaluation Plan" on how healthcare providers can implement them within their clinical environments, as well as a process for evaluating and measuring their effectiveness. "Providers can use the tools and process to start making changes in how transitions occur within their facilities," H. Edward Davidson, PharmD, MPH, and the representative of the American Society of Consultant Pharmacists (ASCP) said. "The goal is that providers are empowered to take the first step at measuring their own performances in transitions of care and identify areas for improvement. These areas include such things as improving how medication changes are reconciled when patients move from a nursing home to a hospital, through the hospital, and through the discharge process." The materials include an educational component about transitions of care, an implementation case study and evaluation methodology.

The released tools address several important areas that impact effective and safe transitions, including:

Personal Patient "My Medicine List" Essential Data Elements: This is a list of medications to be carried at all times by every patient. The data elements indicate the prescriptions that patients have been prescribed and are currently taking along with information about their over-the counter medications, vitamins, and nutritional supplements. The goal of the personal medicine list is to help patients improve their understanding of their current medicine regimens and assist healthcare providers in ensuring safe transference of medication information.

Medication Reconciliation Essential Data Specifications: These consensus elements will help healthcare professionals collect, transmit and receive critical medication information needed when patients move from one practice setting or level of care to another. The use of these elements in the reconciliation process required by the Joint Commission could help reduce medication errors.

Elements of Excellence Transitions of Care Checklist: This list provides a detailed description of effective patient transfer between practice settings. This process can help to ensure that patients and their critical medical information are transferred safely, timely, and efficiently.
In addition, NTOCC authorized the release of materials that will help the industry, consumers, government officials, and regulators better understand the problems inherent in transitions of care and recommendations on how to create better transitions. This material includes an awareness slide deck, as well as a detailed concept paper outlining steps to be considered by the healthcare industry and policy makers to improve transition performance.

Transitions of care include situations in which a patient moves from primary care to specialty physicians or moves within the hospital including moves from the emergency department to other various departments, such as surgery or intensive care; or when a patient is discharged from the hospital and goes home or to an assisted living, skilled nursing facility, or hospice. Patients, especially older persons, face significant challenges when moving from one level of care or practice setting to another in the healthcare system. During these transitions, lack of communication can result in redundant or conflicting information that often creates serious issues for patients, their caregivers and their families.

The NTOCC Advisory Board includes the Academy of Managed Care Pharmacy (AMCP), American Association of Homes and Services for the Aging (AAHSA), American Geriatrics Society (AGS), American Medical Directors Association (AMDA), American Medical Group Association (AMGA), American Society of Health-System Pharmacists (ASHP), American Society on Aging (ASA), American Society of Consultant Pharmacists (ASCP), AXA Assistance USA Inc., Case Management Society of America (CMSA), Consumers Advancing Patient Safety (CAPS), Health Services Advisory Group (HSAG), Institute for Healthcare Improvement (IHI), Joint Commission International Center for Patient Safety (ICPS), Lipitz Center for Integrated Health Care, Mid-America Coalition on Health Care (MACHC), National Association of Directors of Nursing Administration - Long Term Care (NADONA / LTC), National Association of Social Workers (NASW), National Business Coalition on Health (NBCH), National Case Management Network of Canada (NCMN), National Quality Forum (NQF), Predictive Health, LLC, sanofi-aventis U.S., LLC, Society of Hospital Medicine (SHM), The Joint Commission Disease - Specific Care Certification, United Health Group (UHG), URAC, and the United States Department of Defense.

WOW! Over 250 visitors in 48 hours!

I have had some overwhelming response since I went live with the blog! Within 48 hours of our official launch we have had over 250 hits! - I am glad to see that the Arizona Case Management community has been so responsive and I hope you will all come back and visit regularly. I am posting new things everyday!

Thanks for a wonderful start! -Steve

Is there any GOOD news out there anymore?

Several months ago, I took the T.V. out of my bedroom. It was a fitting decision mostly based on the fact that the number of books on my night stand kept piling up and my excuse to not read them was getting rather lame. Usually my excuse was based on procrastination but more specifically wanting to numb myself each night with watching the news and seeing what was new in the world. But where has all that feel good news gone? Has it really dwindled in to one or two news stories a week? - How does this apply to case management you ask? We'll for months, it seems that all I hear about health care is the same; insurance costs skyrocketing, re-use of needles at clinics in Nevada, etc.etc. It gets old people! But I know there are good things happening...and maybe I am just singing the blues after a rough week!

So who else to turn to for good news but Case Managers. They see the "feel good stuff" happen everyday! Please share with me your stories! I will post them! - Names will be kept anonymous, but I really want to hear what is going on out there! I know you all aspire to be eloquent writers so lets here your stuff!

I look forward to the hearing some feel good stories and I promise to send a special prize for the one I like the best! - Funny or heartwarming, I am open to all!

Please email them to me at sathornley@gmail.com

JOB Opportunities Section.......

I received an inquiry about posting jobs to this blog by an employer. I think this is a good forum to have access to these resources as well as many other great things to share. The fact is, that Phoenix is a very robust market for literally dozens of non-clinical nursing and Case Management opportunities at all levels.

To that end, I have created a section of Job Opportunities to the right of the screen and will update them regularly with links to specific information.

Thanks for the inquiry about this and I hope this will be a good resource for all!

Please comment and send me suggestions on how I can improve the blog and any particular topics that we can discuss!

Thanks! Steve

Article: Part D improved prescription compliance

To read this article, click on this link: http://news.yahoo.com/s/nm/20080422/hl_nm/medicare_usa_dc;_ylt=AoP84QzKSsVP3gWTFLMjQokQ.3QA

Too funny to pass up! - You will all enjoy this!

I read this and thought it was perfect for this blog. Enjoy!

Two Doctors & HMO Manager

Two doctors and an HMO manager died and lined up at the pearly gates for admission to heaven. St. Peter asked them to identify themselves.One doctor stepped forward and said: "I was a pediatric spine surgeon and helped kids overcome their deformities."St. Peter said, "You can enter."The second doctor said "I was a psychiatrist. I helped people rehabilitate themselves."St. Peter also invited him in.The third applicant stepped forward and said, "I was an HMO manager. I helped people get cost-effective health care."St. Peter said, "You can come in too." But as the HMO manager walked by, St. Peter added, "You can stay three days. After that, you will be released."

Question Regarding the CCM Examination

Thank you for the recent question about the CCM Examinations. They are conducting the last "paper and pencil" test this month and in the fall the tests will be all computer based.

For more information on taking the CCM exam and becoming certified, visit:

http://www.ccmcertification.org/index.html

Thanks again!

Steve

Case Managers Study Guide for CCM Exam

I came across a company that produces a study guide that may be helpful for this preparing for the CCM exam! Visit: http://www.jbpub.com/ for more info!

Steve

WELCOME New Visitors!

Thanks for stopping by! I hope to hear from many of you and what sort of challenges you are facing in the Case Management world! - I am preparing for my honeymoon of sorts to beautiful Costa Rica, but will keep up with things on the blog so please send me your topics to moderate!

Happy Tuesday!- Steve

Article: Employers seek alcohol abuse options from health plans.

To view this article go to: http://www.aishealth.com/Bnow/hbd041808.html

Please come back here to comment!

How do we look so far Arizona?

I personally wanted to thank all those who have stopped by the blog so far! I hope that you have found the information interesting and informative! Please come back and visit often and please make comments!

Your contributions are greatly appreciated. Also, note that I have added a WEEKLY POLL at the right of this section. I hope you will all vote and I’ll do my part to keep them applicable and interesting!

Have a great Thursday Night!- We are almost to the weekend!

Steve Thornley – sathornley@gmail.com

Article: Patient-Controlled Health Records Could Change Future of Research

WEDNESDAY, April 16 (HealthDay News) -- Increasing patient control of health records could dramatically change how medical research is conducted, say Children's Hospital Boston researchers.
In a Sounding Board article in the April 17 issue of the New England Journal of Medicine, the researchers noted that the shift to personally controlled health records (PCHRs) will give patients and doctors easier access to records during clinical care and will also have a major impact on the conduct of biomedical research.
With PCHRs, patients have Web-based access to almost all the information -- such as lab tests, diagnoses, medications and clinical notes -- in their medical records. They can decide who gets to see that information.
"Giving patients access and control over their medical records will unlock a whole new world where researchers will suddenly be able to recruit hundreds, thousands, possibly millions of patients from all over the world, and have access to new data sets and populations. Imagine the possibilities this will bring and the impact it will have on bringing research to the bedside," article co-author Dr. Isaac Kohane, of the hospital's informatics program, said in a prepared statement.
More than a decade ago, Kohane, colleague Dr. Kenneth Mandl and others on the informatics team at Boston Children's developed the first PCHR.
While PCHRs offer many benefits, there are some potential pitfalls.
"While this is exciting indeed, without forethought and regulation, the tremendous benefit of PCHRs -- for research and clinically -- could easily be overshadowed by problems that could arise from the unethical and uncontrolled use of a patient's valuable medical information," article co-author Dr. Kenneth Mandl said in a prepared statement.
"Who will have access to the data, for what purposes, and under what sort of regulation? Can patients sell their information? How will we establish and protect their identity? These are the kinds of questions -- among many others -- that we need to ask now and clarify before PCHRs become mainstream," Mandl said.
"While PCHRs may seem futuristic, they are here now and will be widely adopted in the not-so-distant future. Fortune 100 companies are already signing on to develop their own PCHRs for their employees. We cannot afford to be asleep at the wheel. Before they hit prime-time, we need to think about what is at stake and what has to happen -- including regulations and standards -- if PCHRs are to be used to the full extent of their potential," Kohane said.

Article: Making the Grade: Doctors say insurance company rankings of doctors are based on cost, not quality. ....

To view this article, please visit:

http://www.newsweek.com/id/132496

And please come back and comment!

Article: Mesa General Closure......

Mesa General staff looking elsewhere as hospital closes
Art Thomason
Apr. 15, 2008 09:39 AM
The Arizona Republic

With the healthcare job market still fit, the name of a familiar Mesa institution is on a surge of new résumés under review by medical service providers in the Southeast Valley.

Employees of Mesa General Hospital wasted no time applying for jobs at other medical centers after the announcement March 25 that it will close June 1.

But Audrianne Schneider, a Mesa General spokeswoman, said Friday the hospital's Tennessee-based owner, Iasis Healthcare, assures that the hospital is sufficiently staffed to serve its patients until the doors are locked.

"We're committed to the same level of care that our patients have come to expect and deserve until June 1," she said. "From the very beginning we said would do our best to retrain as many members of our (hospital) family as we could. We have had several internal job fairs, our employees have shown a great interest in transferring to another Iasis facility and every effort is being made to keep as many employees as possible."

"People are not bailing out," she added. "There are staff that will be transferring to another facility who will stay with us through May 31."

Applications from Mesa General employees are piling up on desks at Banner Health, the state's largest healthcare provider.

"We received between 15 and 20 applications since the announcement that Mesa General was closing," said Rosanna Bailey, recruitment program manager for the Banner east Mesa campus that includes Banner Baywood Medical Center and Banner Heart Hospital. "We've always gotten applicants from them, but not that many in a short amount of time."

Banner Baywood spokeswoman Coiya Lynn said job offers were extended to several applicants but she didn't know when they would start work.

Chandler Regional Medical Center has hired some of the 20 Mesa General nurses who applied for jobs, said the center's marketing and public relations manager, Julie Graham.

Mesa leaders continue to express disappointment that the hospital is closing and residents in neighborhoods near Mesa and University drives say they are concerned that the hospital will become another vacant building in west Mesa.

"I still am wondering why they are closing it," said Jessica Egnew, who lives about a block north of the hospital. "We are worried about what they are going to do with it and we sure don't want it abandoned. And we don't want whatever they put in there to bring down the neighborhood."

Mesa General's closing comes as new medical centers open in the Southeast Valley, including the 178-bed Mountain View Medical Center owned by Iasis Healthcare.

The 43-year-old hospital's landlord, Sierra Land Group Inc., has not announced any plans for the property.

"We want to make sure the land is put to good use," said Patricia Martineau, who lives in a neighborhood east of the hospital. "Every time something is closed down there is always concern about the downturn of the area."

Mesa developer and real estate investor Michael Pollack said continuing to use the hospital for medical services would be the most prudent choice at this time. Its worst use, he said, is office space.

"The highest and best use of that property is medical," he said. "We already have a huge supply of office space in this area and that last thing we need is a whole lot of additional space added to the market."

News Article: Feds Try to Cut Costs of Hospital Errors

Follow this link to read this story:
http://www.forbes.com/feeds/ap/2008/04/14/ap4888243.html

Seeking information on local Emergency Depts. with 24 Hour Case Managers…..

Good Afternoon Case Managers! I am seeking/surveying to find out which Phoenix area Hospitals utilize 24 hour Case Managers specfically assigned to the Emergency Department. Your help will be greatly appreciated! You can reply by making a comment to this post!

Thanks, Steve

A little off topic…but not really! - Top Worst Foods to Eat!

I had this emailed to me recently….we all love to eat out and some of this really surprised me (and then some didn’t) Enjoy!

The Top 20 Worst, Most Unhealthful Foods in America

20: Worst Fast-Food Chicken Meal - Chicken Selects Premium Breast Strips from McDonald’s (5 pieces) with cream ranch sauce. 830 Calories, 55 grams fat (4.5 trans fat), 48 carbs. Add a large fries and regular soda and this seemingly innocuous chicken meal tops out at 1,710 calories.

19: Worst drink - Jamba Juice Chocolate Moo’d Power Smoothie (30 fl oz). 900 calories, 10 g fat, 183 carbs, 166 g sugar. Jamba Juice calls it a smoothie, MSNBC calls it a milk shake. The beverage contains as much sugar as 8 pints of Ben & Jerry’s butter pecan ice cream.

18: Worst supermarket meal - Pepperidge Farm Roasted Chicken Pot Pie (whole pie). 1,020 calories, 64 g fat, 86 g carbs. Label may say this pie serves two, but, who ever divided a small pot pie in half? Once you crack the crust, there will be no stopping.

17: Worst ‘healthy’ burger - Ruby Tuesday Bella Turkey Burger. 1,145 calories, 71 g fat, 56 g carbs.

16: Worst Mexican entree - Chipotle Mexican Grill Chicken Burrito. 1,179 calories, 47 g fat, 125 g carbs, 2,656 mg sodium.

15: Worst kids’ meal - Macaroni Grill Double Macaroni ‘n’ Cheese. 1,210 calories, 62 g fat, 3,450 mg sodium. It’s like feeding your kid 1-1/2 boxes of Kraft mac ‘n’ cheese.

14: Worst sandwich - Quiznos Classic Italian (large). 1,528 calories, 92 g fat, 4,604 mg sodium, 110 g carbs. A large homemade sandwich would more likely provided about 500 calories.

13: Worst salad - On the Border Grande Taco Salad with Taco Beef. 1,450 calories, 102 g fat, 78 g carbs, 2,410 mg sodium. This isn’t an anomaly: Five different On the Border salads on the menu contain more than 1, 100 calories each.

12: Worst burger - Carl’s Jr. (Hardee’s on East Coast) Double Six Dollar Burger. 1,520 calories! , 111g fat. Carl’s Jr. brags it’s home to this enormous sandwich, but the restaurant chain also provides convenient nutrition info on its Web site — so ignorance is no excuse for eating it.

11 : Worst steak - Lonestar 20 oz T-bone. 1,540 calories, 124g fat. Add a baked potato and Lonestar’s Signature Lettuce Wedge, and this is a 2,700 calorie blowout.

10: Worst breakfast - Bob Evans Caramel Banana Pecan Cream Stacked and Stuffed hotcakes. 1,540 calories, 77 g fat (9 g trans fat), 198 g carbs, 109 g sugar. Five Egg McMuffins yield the same caloric cost as this stack of sugar-stuffed flapjacks, which is truly a heavy breakfast, weighing in at a hefty pound and a half.

9: Worst dessert - Chili’s Chocolate Chip Paradise Pie with Vanilla Ice Cream. 1,600 calories, 78 g fat, 215 g carbs. Would you eat a Big Mac for dessert? How about three? That’s the calorie equivalent of this decadent dish. Clearly, Chili’s customers get their money’s worth.

8: Worst Chinese entree - P.F. Chang’s Pork Lo Mein. 1,820 calories, 127 g fat,! 95 g carbs. The fat content in this dish alone provides more than 1,100 calories. And you’d have to eat almost five servings of pasta to match the number of carbs it contains. Now, do you really need five servings of pasta?

7: Worst chicken entree - Chili’s Honey Chipotle Crispers with Chipotle Sauce. 2,040 calories, 99 g fat, 240 g carbs. ‘Crispers’ refers to an extra thick layer of break crumbs that soak up oil and adds unnecessary calories and carbs to these glorified chicken strips.

6: Worst fish entree - On the Border Dos XX Fish Tacos with Rice and Beans. 2,100 calories, 130 g fat, 169 g carbs, 4,700 mg sodium. Perhaps the most misleadingly named dish in America : A dozen crunchy tacos from Taco Bell will saddle you with fewer calories.

5: Worst pizza - Uno Chicago Grill Chicago Classic Deep Dish Pizza. 2,310 calories, 162 g fat, 123 g carbs, 4,470 mg sodium. Downing this ‘personal’ pizza is equivalent to eating 18 slices of Domino’s Crunchy Thin Crust cheese pizza.

4: Worst pasta - Macaroni Grill Spaghetti and Meatballs with Meat Sauce. 2,430 calories, 128 g fat, 207 g carbs, 5,290 mg sodium. This meal satisfied your calorie requirements for an entire day.

3: Worst nachos - On the Border Stacked Border Nachos. 2,740 calories, 166 g fat, 191 g carbs, 5,280 sodium.

2: Worst starter - Chili’s Awesome Blossom. 2,710 calories, 203 g fat, 194 g carbs, 6,360 mg sodium.

1: The worst food in America - Outback Steakhouse Aussie Cheese Fries with Ranch Dressing. 2,900 calories, 182g fat, 240g carbs. Even if you split these ’starters’ with three friends, you’ll have downed a dinner’s worth of calories before you entree arrives.

WOW!

Article: Researchers Find Gene Mutation That Increases Asthma Risk

Great article! Link to it at:
http://health.usnews.com/usnews/health/healthday/080409/researchers-find-gene-mutation-that-increases-asthma-risk.htm

Article: “…patient centered case management results in 38% decrease in hospital admissions….”

I found this article dated Feb 15, 2007..It may be a little old, but good information on the impact Case Management has on healthcare!
Visit this link for the article: http://www.cmu.edu/news/archive/2007/February/feb15_blueshield.shtml
-ST

Salary.com report of Arizona Case Management Salaries

Salary.com reports that Arizona Nurse Case Managers Average between $52,791/year (25th percentile) and $68,255/year (90th percentile). Usefull information when assessing your employment situation and new opportunities.

Greetings Arizona Case Managers!

Welcome to the Arizona Nurse Case Management Blog! It is hoped that this will be an excellent forum for the exchange of information beneficial to the Case Management community! Please join me as I moderate posts and comments of useful and helpful information that will benefit our niche in the Healthcare field!

-Steve Thornley

More to come.....

Just starting this new blog! More to come!