Broad-based, integrated, community-wide initiatives can help keep seniors out of the hospital, says an important new study from the Journal of the American Medical Association. The study, done by a team led by Dr. Joanne Lynn of the Altarum Institute’s Center on Elder Care and Advanced Illness is new evidence that by working together, hospitals, physicians, social workers, nursing homes, [...]
Too many people make the dangerous roundtrip from hospital to nursing facility and back again. These transfers may increase risks of delirium, medication errors, falls, and infection. There is no doubt that some patients die as a result of these transfers. And, they cost payers—Medicare, Medicaid, and private insurance—hundreds of millions of dollars each year. The real tragedy: By some [...]
While many seniors and their families may not be aware of it, consumer groups, hospitals, and nursing homes are fighting a major battle with Medicare over how the federal program pays for patients who are cared for in a hospital, but not admitted to the hospital. Seniors caught in this regulatory purgatory may have to pay thousands of dollars for [...]
What if you could be admitted to the hospital—in your own bedroom? That’s the idea of a health care model called Hospital at Home, which is aimed at elderly patients with diseases such as congestive heart failure, emphysema, urinary tract infections, or pneumonia. According to a new study published in the journal Health Affairs, people receiving this care through the [...]
I recently had the opportunity to participate in a panel on end-of-life care jointly sponsored the Charles E. Smith Life Communities in Rockville MD, Suburban Hospital in Bethesda, MD,, and Sibley Hospital in Washington, D.C. The session was part of a day-long program on care transitions and highlighted the special importance of caring for the dying. My fellow panelists and I brought a wide [...]
Hospital-based palliative care programs that focus on patient comfort rather than simply medical treatment are growing rapidly. And for patients, their families, and hospitals themselves, that is a very good thing. A new study by the National Palliative Care Research Center finds the number of these important new programs has grown from 600 to more than 1500 over the past decade. Of the nation's [...]
Skilled nursing facilities whose patients are too frequently admitted to the hospital would face stiff new penalties according to the deficit reduction plan proposed by President Obama on Sept. 20. These admissions are often caused by falls, infections, or poor medication management. Overall, as part of a broad deficit reduction plan, Obama would cut more than $300 billion from projected [...]
We all know the sad story: Despite extensive rehab, a patient in a skilled nursing facility is failing. Instead of improving, she is finds herself returning to the local hospital with trouble breathing, heart failure, or unmanaged pain. Eventually, she may die in the hospital hooked up to a ventilator and feeding tube that she never wanted. A team at [...]
Next week, I'll be speaking to faculty and others at the University of Massachusetts School of Medicine on the importance of fully integrating long-term care services and supports with medical care. On May 23, I'll be delivering the same message to a large non-profit health system that includes more than two dozen hospitals. Physicians and health system adminstrators are beginning to get it: [...]
I recently had the pleasure of speaking to NICHE, (Nurses Improving Care for Healthsystem Elders) a joint venture of the Hartford Institute and the New York University School of Nursing dedicated to improving the quality of geriatric nursing. NICHE understands that caring for elders is not like caring for younger patients, and it has developed new techniques to both assess [...]