STAFFING: The Pivotal Role of RNs
|
|
|
- Hugh Quinn
- 5 years ago
- Views:
Transcription
1 STAFFING: The Pivotal Role of RNs RN Staffing Standards: Medicare Requirements and the Joint Commission Standards November 16, 2007
2 Patients go to the hospital for an intervention and stay in the hospital for the nursing care
3 RNs make the difference Studies show that patients in medical-surgical units with a 1:8 nurse to patient ratio are 31% more likely to die within 30 days than those in units with RN to patient ratios of 1:4, and complications such as infections, pneumonia, shock and gastrointestinal bleeding are much more prevalent with fewer nurses. Adding just one more patient to an RN s patient list results in a 7% higher morbidity and mortality rate. (L. Aiken at al., Hospital Nurse Staffing and Patient Mortality, Nurse Burnout and Job Dissatisfaction, 288 JAMA (2002).
4 RNs make the difference Higher rates of patient falls are associated both with fewer nursing hours per day and a lower percentage of RNs. Dunton,N., Gajewski, B., Taunton R.L. and Moore, J. (2004). Nurse Staffing and Patient Falls on Acute Care Hospital Units, Nursing Outlook, 52(1), Higher numbers of RN hours of care per day associated with: shorter length of stay; lower rates of UTI, upper GI bleeding, pneumonia, cardiac arrest and failure to rescue. Needleman, J., Buerhaus, P., Mattke, S., Stewart, M., and Zelevinsky, K., (2002) Nurse Staffing Levels and Quality of Care in Hospitals, New England Journal of Medicine 346 (22), ; Policy, Politics & Nursing Practice, 3:
5 The RNs Experience: On a Medical/Surgical Unit there were only two RNs on duty for 23 patients, all over 65 years of age. In an ER department one RN was on duty, assigned to adult walk-in triage, with no patient care assistance; she saw 120 patients during a 10 hour period. On an Intensive Care Unit, there were only two RNs for 12 patients. On an Intensive Care unit, there was an inadequate number of staff to cover the care of three ventilated patients along with 8 other high acuity patients. At least one registered nurse received no breaks, including no meal break. On an ambulatory care unit, a registered nurse was forced to ask a family member of the patient to assist with transport when she was unable to transport the patient herself because of patient load.
6 What did the RNs have in common? They worked in hospitals that were accredited by the Joint Commission and were eligible to participate in the multibillion dollar Medicare program. ANA s view - Hospitals that participate in Medicare should meet the basic requirements of the program.
7 CMS Condition of Participation for the Medicare Program 42 C.F.R (b) Standard: Staffing and delivery of care. The nursing service must have adequate numbers of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed. There must be supervisory and staff personnel for each department or nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.
8 The Joint Commission Standards NR A nurse executive directs the hospital s nursing services. HR The hospital provides an adequate number and mix of staff that are consistent with the hospital s staffing plan. HR The hospital uses data from clinical/service screening indicators and human resource screening indicators to assess and continuously improve staffing effectiveness.
9 The Problem The Joint Commission standards do not focus on RN staffing The standard is lower than the CMS requirement The Joint Commission s non-prescriptive approach is too loose There are not enough RNs to render bedside care when needed, but it doesn t show up in the survey Inadequate RN staffing doesn t matter because there is no RN staffing standard
10 The Lawsuit Against HHS ANA, NYSNA and WSNA sued HHS in June 2006 The Joint Commission s accreditation is equivalent to approval for participation in the Medicare program, provided that the Commission standards are as high as those standards that the HHS Secretary finds necessary in the interest of the health and safety of individuals who are furnished services in the hospital. The Joint Commission s RN staffing standard is lower than that of HHS/CMS. The Secretary of HHS remains ultimately responsible for ensuring safeguards in the Medicare Program.
11 The Status of the Case HHS filed a Motion to Dismiss ANA et al. filed an Opposition and an Amended Complaint The case was stayed while ANA, NYSNA and WSNA talked with the Joint Commission The case was reactivated and the motion to dismiss was denied as moot HHS will file a second motion to dismiss ANA will file its opposition in December 2007
12 Some progress - On an informal/internal basis, the Joint Commission may: focus more on staffing plans look at the role of the chief nurse executive develop more staffing-sensitive aspects of the tracer methodology during surveys Note: The HHS Inspector General has included in the 2008 work plan a study [to] evaluate the extent and adequacy of CMS s policies and procedures regarding the Joint Commission hospital accreditation process.
13 ANA s Assessment Without a change in the Joint Commission standard, there is no way to know if hospitals will meet the mark as defined by CMS Without a change in the RN standard, the nurse executive does not have something to take to the CEO as a basis for funding higher RN staffing levels Without a change in the standard, improvement will be discretionary and will be accomplished too slowly
14 ANA s Proposed Standard Standard NR.4.10 The nursing service must have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed. There must be registered nurse supervisors, registered nurses, and other personnel for each department and nursing unit to ensure, when needed, the immediate availability of a registered nurse for bedside care of any patient.
15 Implementing the proposed standard: elements of performance Nurse staffing levels are determined and implemented based on factors present on each unit during each shift, including Numbers of patients. Patient condition, including severity of illness. Experience level and expertise of assigned staff. Activity on the patient care unit, including admissions, discharges and transfers.
16 Performance elements should include Availability of personnel and services (such as clerical, transport, housekeeping, pharmacy, laundry and laboratory) that enable nurses to devote more of their time to patient care. Presence, numbers and needs for staff nurse oversight of nursing students, new graduates, orientees, float and agency nurses, as well as trainees in other disciplines who require nursing support. Analysis of unit-level nursing-sensitive outcomes data. Contextual issues including architecture of the environment and available technology.
17 Performance elements should include In order to provide transparency and to provide a means to assist hospital leadership and the Joint Commission to ensure ongoing assessment and review of staffing adequacy, current unitlevel data on nurse staffing levels are posted in locations that are available and accessible to patients, visitors and staff Posted data include actual numbers of patients, registered nurses, licensed practical nurses, unlicensed nursing staff providing direct patient care on each unit with comparisons to the unit s normal staffing plan.
18 Performance elements should include Posted data are updated on each shift. Information posted shall include the name(s), contact telephone numbers and addresses of individuals for patients and/or family members to contact to ask questions or voice concerns about nurse staffing levels, along with the telephone number to voice concerns or complaints to the Joint Commission. Posted staffing plan that shows the number and types of staff to meet patient needs.
19 The Nurse Executive In addition, Elements of Performance for Standard 1.10 should ensure that the hospital s nurse executive maintains a direct reporting relationship to the hospital s Chief Executive Officer.
20 A Call to Action Work toward enforcement of HHS/CMS regulations regarding RN staffing Call upon the Joint Commission to develop and use an RN staffing standard that ensures adequate nurse staffing Report unsafe staffing Support nursing education Support staffing legislation
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA AMERICAN NURSES ASSOCIATION, 8515 Georgia Avenue Suite 400 Silver Spring, MD 20910 and CIVIL ACTION NEW YORK STATE NURSES ASSOCIATION, 11 Cornell
"Nurse Staffing" Introduction Nurse Staffing and Patient Outcomes
"Nurse Staffing" A Position Statement of the Virginia Hospital and Healthcare Association, Virginia Nurses Association and Virginia Organization of Nurse Executives Introduction The profession of nursing
The Coalition of Geriatric Nursing Organizations
- The Coalition of Geriatric Nursing Organizations Representing 28,700 Nurses American Academy of Nursing (AAN) Expert Panel on Aging American Assisted Living Nurses Association (AALNA) American Association
Patient Safety: Rights of Registered Nurses When Considering a Patient Assignment
Position Statement Patient Safety: Rights of Registered Nurses When Considering a Patient Assignment Effective Date: March 12, 2009 Status: Revised Position Statement Originated By: Congress on Nursing
New Research That Illuminates Policy Issues: Balancing Nursing Costs and Quality of Care for Patients
Charting A Publication of the Robert Wood Johnson Foundation Nursing s Future Reports on Policies That Can Transform Patient Care New Research That Illuminates Policy Issues: Balancing Nursing Costs and
Staffing and Scheduling
Staffing and Scheduling 1 One of the most critical issues confronting nurse executives today is nurse staffing. The major goal of staffing and scheduling systems is to identify the need for and provide
Nursing Resources, Workload, the Work Environment and Patient Outcomes
Nursing Resources, Workload, the Work Environment and Patient Outcomes NDNQI Conference 2010 Christine Duffield, Michael Roche, Donna Diers Study Team Professor Christine Duffield Michael Roche Professor
BEDSIDE NURSES KNOW: The Patient Safety Act. Fewer Patients = Better Healthcare. A Toolkit for Massachusetts RNs. How you can help make safe limits
The Patient Safety Act BEDSIDE NURSES KNOW: Fewer Patients = Better Healthcare A Toolkit for Massachusetts RNs How you can help make safe limits on RN patient loads a reality This booklet provides you
Mandatory Nurse Staffing Models for Patient Safety Linda Silas Canadian Federation of Nurses Unions
Mandatory Nurse Staffing Models for Patient Safety Linda Silas Canadian Federation of Nurses Unions April 13, 2013 Honor Society of Nursing, Sigma Theta Tau International Health care institutions are running
Executive Summary Leapfrog Hospital Survey and Evidence for 2014 Standards: Nursing Staff Services and Nursing Leadership
TO: FROM: Joint Committee on Quality Care Cindy Boily, MSN, RN, NEA-BC Senior VP & CNO DATE: May 5, 2015 SUBJECT: Executive Summary Leapfrog Hospital Survey and Evidence for 2014 Standards: Nursing Staff
SENATE, No. 989 STATE OF NEW JERSEY. 218th LEGISLATURE INTRODUCED JANUARY 16, 2018
SENATE, No. STATE OF NEW JERSEY th LEGISLATURE INTRODUCED JANUARY, 0 Sponsored by: Senator JOSEPH F. VITALE District (Middlesex) Senator LORETTA WEINBERG District (Bergen) Co-Sponsored by: Senator Gordon
1. Recommended Nurse Sensitive Outcome: Adult inpatients who reported how often their pain was controlled.
Testimony of Judith Shindul-Rothschild, Ph.D., RNPC Associate Professor William F. Connell School of Nursing, Boston College ICU Nurse Staffing Regulations October 29, 2014 Good morning members of the
PROTECTING. OUR PATIENTS: Staffing in Health Care Settings
PROTECTING OUR PATIENTS: Staffing in Health Care Settings Current RN Staffing Regulations, Guidelines and Standards to Support our Campaigns for Safe Staffing Staffing in Healthcare Settings Updated December
Nurse-to-Patient Ratios
N U R S I N G M A T T E R S Nursing Matters fact sheets provide quick reference information and international perspectives from the nursing profession on current health and social issues. Nurse-to-Patient
Discussion Paper A Review of Minimum Staffing Ratios for Direct-Care Registered Nurses in Hospitals
Discussion Paper A Review of Minimum Staffing Ratios for Direct-Care Registered Nurses in Hospitals Catherine Ormond, M.S. Research Associate Institute for Health Policy Muskie School of Pubic Service
Current policy context of safe staffing in A&E Departments
Current policy context of safe staffing in A&E Departments Howard Catton, Head of Policy and International Affairs Hallam Conference Centre, London -18 th May 2015 Why is safe staffing so important? Right
Illinois Hospital Report Card Act
Illinois Hospital Report Card Act Public Act 93-0563 SB59 Enrolled p. 1 AN ACT concerning hospitals. Be it enacted by the People of the State of Illinois, represented in the General Assembly: Section 1.
MINIMUM STANDARDS FOR INTENSIVE CARE UNITS SEEKING ACCREDITATION FOR TRAINING IN INTENSIVE CARE MEDICINE
College of Intensive Care Medicine of Australia and New Zealand ABN: 16 134 292 103 Document type: Policy Date established: 1994 Date last reviewed: 2015 MINIMUM STANDARDS FOR INTENSIVE CARE UNITS SEEKING
Hospital Crosswalk. Medicare Hospital Requirements to 2012 Joint Commission Hospital Standards & EPs
Hospital Crosswalk CFR Number Standards and Elements of Performance 482.11 TAG: A-0020 482.11 Condition of Participation: Compliance with Federal, State and Local Laws 482.11(a) TAG: A-0021 LD.04.01.01
AN ACT RELATIVE TO PATIENT SAFETY
AN ACT RELATIVE TO PATIENT SAFETY SECTION 1. Chapter 118G of the General laws, as appearing in the 2004 Official Edition, is hereby amended by adding the following new section:- Section 28: a. The division
Medicare Program; Announcement of the Approval of the American Association for
This document is scheduled to be published in the Federal Register on 03/23/2018 and available online at https://federalregister.gov/d/2018-05892, and on FDsys.gov BILLING CODE 4120-01-P DEPARTMENT OF
Practical steps for applying. in acuity-based staffing
Practical steps for applying Lillee Gelinas, MSN, RN, FAAN (Moderator) System Vice President and Chief Nursing Officer Clinical Excellence Services CHRISTUS Health Irving, Texas Editor-in-Chief, American
Medicare Program; Announcement of the Reapproval of the Joint Commission as an
This document is scheduled to be published in the Federal Register on 05/25/2018 and available online at https://federalregister.gov/d/2018-11330, and on FDsys.gov [Billing Code: 4120-01-P] DEPARTMENT
Chapter 39. Nurse Staffing, Models of Care Delivery, and Interventions
Chapter 39. Nurse Staffing, Models of Care Delivery, and Interventions Jean Ann Seago, Ph.D., RN University of California, San Francisco School of Nursing Background Unlike the work of physicians, the
Nearly two-thirds of RNs working in Michigan hospitals believe staffing levels are based more on financial factors than on patient acuity.
Memorandum To: From: Michigan Nurses Association Chris Anderson, Lauren Coates Date: March 21, 2016 RE: Survey of Michigan Registered Nurses This memorandum summarizes the key findings from a statewide
Understanding Patient Choice Insights Patient Choice Insights Network
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Understanding Patient Choice Insights Patient Choice Insights Network SM www.aetna.com Helping consumers gain
AF4Q and TCAB: An Introduction
AF4Q and TCAB: An Introduction July 13, 2011 Ellen Interlandi, MHM, RN, NE-BC Patricia Montoya, MPA, BSN 1 What is Aligning Forces for Quality? An unprecedented commitment by the Robert Wood Johnson Foundation
Overview of the Federal 340B Drug Pricing Program
Overview of the Federal 340B Drug Pricing Program Presented by: James A. Raley, CPA Senior Manager Health Care Services Arnett Carbis Toothman LLP 345 340B Program: Overview Provides discounts on outpatient
Nurse staffing & patient outcomes
Nurse staffing & patient outcomes Jane Ball University of Southampton, UK Karolinska Institutet, Sweden Decades of research In the 1980 s eg. - Hinshaw et al (1981) Staff, patient and cost outcomes of
Evaluation of Selected Components of the Nurse Work Life Model Using 2011 NDNQI RN Survey Data
Evaluation of Selected Components of the Nurse Work Life Model Using 2011 NDNQI RN Survey Data Nancy Ballard, MSN, RN, NEA-BC Marge Bott, PhD, RN Diane Boyle, PhD, RN Objectives Identify the relationship
Program objectives; All patient care disciplines; Description of how the program will be administered and coordinated;
A self-assessment is conducted. Can be accomplished through methods such as review of current documentation, patient care, direction observation of clinical performance, operating systems or interviews
HB 2201/Nursing Home Staffing
HB 2201/Nursing Home Staffing Preventing injury, illness and death through improved nurse staffing Kansas Advocate for Better Care // AARP Kansas Current Kansas Standards Unsafe for Frail Elders The current
The Safe Staffing for Quality Care Act will have a profound impact on the Advanced
Anne Marie Holler NUR 503 Group Project- Safe Staffing for Quality Care Act 11/21/11 Impact of Safe Staffing for Quality Care Act The Safe Staffing for Quality Care Act will have a profound impact on the
3/14/2014. Preventing Rehospitalizations How to Change Your When in Doubt, Send em Out Way of Thinking. Objectives. Background Information
Preventing Rehospitalizations How to Change Your When in Doubt, Send em Out Way of Thinking Jennifer Moore, RN Content Developer Objectives Describe two reasons why returns to the hospital are not desirable
LOUISIANA MEDICAID PROGRAM ISSUED: 06-09/17 REPLACED: 03/14/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.1: PROVIDER REQUIREMENTS PAGE(S) 15
PROVIDER REQUIREMENTS A provider must be enrolled in the Medicaid Program and meet the provider qualifications at the time service is rendered to be eligible to receive reimbursement through the Louisiana
Comparison of the current and final revisions to the Home Health Conditions of Participation
Comparison of the current and final revisions to the Home Health Conditions of Participation Significant changes are designated by ** underlined, and bolded. Where the condition or standard is ** and underlined,
Health Management Policy
Health Management Policy Policy Number: 0101 Effective Date: 4/1/18 Policy Title: Circumvention of PPS/Readmission Review Applies To: Generations Advantage Purpose: The Martin s Point Health Care Medicare
(9) Efforts to enact protections for kidney dialysis patients in California have been stymied in Sacramento by the dialysis corporations, which spent
This initiative measure is submitted to the people in accordance with the provisions of Article II, Section 8, of the California Constitution. This initiative measure amends and adds sections to the Health
A project of the Office of Nursing Workforce Research, Planning, and Development University of Vermont College of Nursing and Health Sciences Funded
A project of the Office of Nursing Workforce Research, Planning, and Development University of Vermont College of Nursing and Health Sciences Funded by the Vermont Department of Health Health Workforce
Effective Tools to Prevent and Manage Adverse Events
Effective Tools to Prevent and Manage Adverse Events Based on Office of Inspector General Adverse Events Report Diane C. Vaughn, RN, C-DONA/LTC; LNHA vaughndiane@hotmail.com Objectives Upon completion
DOI: / Page
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 11 Ver. IV (Nov. 2015), PP 31-35 www.iosrjournals.org A Study on Contract Nurse Staffing as
UnitedHealthcare Medicare Readmission Review Program for Medicare Advantage Plans General Clinical Guidelines for Payment Review
UnitedHealthcare Medicare Readmission Review Program for Medicare Advantage Plans General Clinical Guidelines for Payment Review Introduction The UnitedHealthcare Medicare Readmission Review Program is
THE 2017 QUALIS HEALTH AWARDS OF EXCELLENCE IN HEALTHCARE QUALITY IN WASHINGTON
THE 2017 QUALIS HEALTH AWARDS OF EXCELLENCE IN HEALTHCARE QUALITY IN WASHINGTON Since 2002, Qualis Health has presented the annual Awards of Excellence in Healthcare Quality to outstanding organizations
Patient Care First COALITION FOR PATIENT RIGHTS AND SAFE STAFFING IN NEW JERSEY
Patient Care First COALITION FOR PATIENT RIGHTS AND SAFE STAFFING IN NEW JERSEY A Summary of Nurse Staffing Studies: Impact on Patient Outcomes, Costs, Patient & Nursing Satisfaction Patient Deaths: A
Using Telemedicine to Improve Outcomes and Collaboration Within Hospitals and Health Systems
American Hospital Association Leadership Summit Using Telemedicine to Improve Outcomes and Collaboration Within Hospitals and Health Systems Please note that the views expressed by the conference speakers
Nursing skill mix and staffing levels for safe patient care
EVIDENCE SERVICE Providing the best available knowledge about effective care Nursing skill mix and staffing levels for safe patient care RAPID APPRAISAL OF EVIDENCE, 19 March 2015 (Style 2, v1.0) Contents
Cost Effectiveness of Physician Anesthesia J.P. Abenstein, M.S.E.E., M.D. Mayo Clinic Rochester, MN
Mayo Clinic Rochester, MN Introduction The question of whether anesthesiologists are cost-effective providers of anesthesia services remains an open question in the minds of some of our medical colleagues,
The Rising Importance of Patient Satisfaction in a Value-Based Environment
The Rising Importance of Patient Satisfaction in a Value-Based Environment Why Now is the Time to Focus on Employee Engagement Strategies to Improve the Patient Experience and Boost the Bottom Line Hospitals
PG snapshot Nursing Special Report. The Role of Workplace Safety and Surveillance Capacity in Driving Nurse and Patient Outcomes
PG snapshot news, views & ideas from the leader in healthcare experience & satisfaction measurement The Press Ganey snapshot is a monthly electronic bulletin freely available to all those involved or interested
Institutional Handbook of Operating Procedures Policy
Section: Clinical Policies Institutional Handbook of Operating Procedures Policy 09.01.13 Responsible Vice President: EVP and CEO Health System Subject: Admission, Discharge, and Transfer Responsible Entity:
LONG TERM CARE SETTINGS
LONG TERM CARE SETTINGS Long term care facilities assist aged, ill or disabled persons who can no longer live independently. In this section, we will briefly examine the history of long term care facilities
In 2004 the institute for Healthcare Improvements
CE Home Study Course Rapid Response Teams Another Safety Scheme? Description. This home study examines the proliferating usage of Rapid Response Teams (RRT), a team of critical care experts established
NON-HOSPITAL MEDICAL AND SURGICAL FACILITIES ACCREDITATION PROGRAM Accreditation Standards. Overnight Stay
NON-HOSPITAL MEDICAL AND SURGICAL FACILITIES ACCREDITATION PROGRAM NON-HOSPITAL MEDICAL AND SURGICAL FACILITIES ACCREDITATION PROGRAM INTRODUCTION Overnight stay is considered a post-anesthesia level of
Operational Assessments: Utilizing Productivity Standards
Operational Assessments: Utilizing Productivity Standards Mary Klimp CEO Queen of Peace Hospital 952.758.8101 mklimp@qofp.org Ross Manson Principal Eide Bailly 701.239.8634 rmanson@eidebailly.com Agenda
Billing Policies and Procedures WVU Physicians of Charleston
Billing Policies and Procedures WVU Physicians of Charleston POLICY/PROCEDURE NO.: B-10 10/1/15 Section: Chapter: Policy: Compliance Billing Teaching Physician Requirements Evaluation and Management (E/M)
Future Proofing Healthcare: Who Knows?
Future Proofing Healthcare: Who Knows? Marcel Loh Chief Executive, Swedish Suburban Hospitals & Affiliates Swedish Health Services 2 3 4 Things do not happen. Things are made to happen. John F. Kennedy
Telemedicine: Solving the Root Causes for Preventable 30-day Readmissions in SNF Settings
For Immediate Release: 05/11/18 Written By: Scott Whitaker Telemedicine: Solving the Root Causes for Preventable 30-day Readmissions in SNF Settings Outlining the Problem: Reducing preventable 30-day hospital
Quality Improvement Plan
Quality Improvement Plan Agency Mission: The mission of MMSC Home Care Plus is to at all times render high quality, comprehensive, safe and cost-effective home health care and public health services to
Kronos for Healthcare. In times of uncertainty, your people plan is the key to stability and success
Kronos for Healthcare In times of uncertainty, your people plan is the key to stability and success By hosting healthcare workforce management in the cloud and using analytics, Saint Mary s Hospital was
Solution Title Reducing Patient Harm: Multidisciplinary Teamwork leads to Hospital -wide Success
Organization Frederick Memorial Hospital Solution Title Reducing Patient Harm: Multidisciplinary Teamwork leads to Hospital -wide Success Program / Project Description, including Goals: Statistics regarding
Florida Health Care Association 2013 Annual Conference
Florida Health Care Association 2013 Annual Conference The Westin Diplomat Resort & Spa Session #53 Assess and Educate to Prevent Rehospitalizations Thursday, August 8 10:00 to 11:30 a.m. Regency 1 Upon
Value Based Care in LTC: The Quality Connection- Phase 2
Value Based Care in LTC: The Quality Connection- Phase 2 Joseph J. Tomaino, M.S., R.N., Principal Healthcare Transformation Consulting ChemRx/PharmMerica Geriatric Skilled Nursing Seminar December 7, 2017
Nurse Staffing Committee Charter April 2, 2018
Nurse Staffing Charter April 2, 2018 Introduction This document was created in March of 2018 as a collaborative effort between WSHA, SEIU 1199NW, UFCW 21, and WSNA. These organizations came together in
Gantt Chart. Critical Path Method 9/23/2013. Some of the common tools that managers use to create operational plan
Some of the common tools that managers use to create operational plan Gantt Chart The Gantt chart is useful for planning and scheduling projects. It allows the manager to assess how long a project should
Trends in the Use of Contract Labor among Hospitals
Trends in the Use of among Hospitals A study by: Paul Shoemaker President and CEO American Hospital Directory, Inc. www.ahd.com Douglas H. Howell Senior Vice President, Organization and Performance Norton
Patient Safety and Respiratory Care Staffing Strategies: Presented By
Patient Safety and Respiratory Care Staffing Strategies: Presented By Dan Grady, RRT, FAARC, M Ed. Clinical Specialist for Research and Education Mission Health System Asheville, NC AARC Congress 2012
Nurse staffing: Key to good patient, nurse, and financial outcomes
Nurse staffing: Key to good patient, nurse, and financial outcomes Lynn Unruh, PhD, RN, LHRM Department of Health Management & Informatics University of Central Florida lunruh@mail.ucf.edu 136 Annual APHA
Survey of Nurse Employers in California 2014
Survey of Nurse Employers in California 2014 Conducted by UCSF Philip R. Lee Institute for Health Policy Studies, California Institute for Nursing & Health Care, and the Hospital Association of Southern
The Nexus of Quality and Finance
The Nexus of Quality and Finance Kristen Geissler Pat Ercolano March 4, 2014 Transition from Volume to Value: IHI Triple Aim IHI Triple Aim Improve patient experience of care (quality & satisfaction) Improve
Safe Staffing- Safe Work
Safe Staffing- Safe Work PROFESSIONAL ISSUES CONFERENCE JUNE 2, 2017 SARA MARKLE-ELDER, ALICE BARDEN, RN AFT Nurses and Health Professionals is accredited as a provider of continuing nursing education
Critical Access Hospitals & Compliance Programs. Gregory N. Etzel, Esq. B. Scott McBride, Esq. Health Industry Group Vinson & Elkins LLP
Critical Access Hospitals & Compliance Programs Gregory N. Etzel, Esq. B. Scott McBride, Esq. Health Industry Group Vinson & Elkins LLP History and Background Critical Access Hospitals ( CAH )were established
When RNs are Expected to Work with Limited Resources
When RNs are Expected to Work with Limited Resources An RN may find it challenging to meet her professional obligations in providing safe, competent and ethical care, when working with limited resources,
HEALTH CARE REFORM IN THE U.S.
HEALTH CARE REFORM IN THE U.S. A LOOK AT THE PAST, PRESENT AND FUTURE Carolyn Belk January 11, 2016 0 HEALTH CARE REFORM BIRTH OF THE AFFORDABLE CARE ACT Health care reform in the U.S. has been an ongoing
MEASURING POST ACUTE CARE OUTCOMES IN SNFS. David Gifford MD MPH American Health Care Association Atlantic City, NJ Mar 17 th, 2015
MEASURING POST ACUTE CARE OUTCOMES IN SNFS David Gifford MD MPH American Health Care Association Atlantic City, NJ Mar 17 th, 2015 Principles Guiding Measure Selection PAC quality measures need to Reflect
Accreditation Manager
Guideline Name: Clinical Learning for Junior Doctors Consultation and Date Approved: Accreditation Committee approval: 18 September 2017 Review: 2020 Responsible Officer: Purpose and Scope Accreditation
INCREASE ACCESS TO PRIMARY CARE SERVICES BY ALLOWING ADVANCED PRACTICE REGISTERED NURSES TO PRESCRIBE
INCREASE ACCESS TO PRIMARY CARE SERVICES BY ALLOWING ADVANCED PRACTICE REGISTERED NURSES TO PRESCRIBE Both nationally and in Texas, advanced practice registered nurses have helped mitigate the effects
How Are Florida s Different Home Care Providers Regulated?
PROVIDER 1. What services can be legally provided? ¹ ² Home health aide nursing assistant (CNA) (te: Some home health agencies only provide the above services) Nursing (LPN, RN) Therapy: Physical, Speech,
Healthcare-Associated Infections: State Plans
Healthcare-Associated Infections: State Plans Department of Health & Human Services Office of the Secretary Office of Public Health & Science Web Conference Wednesday, August 19, 2009 Goals Provide background
Subpart C Conditions of Participation PATIENT CARE Condition of participation: Patient's rights Condition of participation: Initial
Subpart C Conditions of Participation PATIENT CARE 418.52 Condition of participation: Patient's rights. 418.54 Condition of participation: Initial and comprehensive assessment of the patient. 418.56 Condition
Managing employees include: Organizational structures include: Note:
Nursing Home Transparency Provisions in the Patient Protection and Affordable Care Act Compiled by NCCNHR: The National Consumer Voice for Quality Long-Term Care, April 2010 Part I Improving Transparency
Neglect Critical Element Pathway
Use this pathway for concerns in structures or processes that have led to resident outcome such as unrelieved pain, avoidable pressure injuries, poor grooming, avoidable dehydration, lack of continence
Using People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers
Using People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers Melissa A. Fitzpatrick, RN, MSN, FAAN VP & Chief Clinical Officer, Hill-Rom Trends Driving Our Industry Aging
The Global Quest for Practice-Based Evidence An Introduction to CALNOC
The Global Quest for Practice-Based Evidence An Introduction to CALNOC Presented on Behalf of the CALNOC TEAM by Diane Brown RN, PhD, FNAHQ, FAAN Nancy Donaldson RN, DNSc, FAAN CALNOC Strategic Overview
CHAPTER SIX STANDARDS FOR NURSING EDUCATION PROGRAMS
CHAPTER SIX STANDARDS FOR NURSING EDUCATION PROGRAMS SECTION I APPROVAL OF PROGRAMS This chapter presents the Standards established by the Arkansas State Board of Nursing for nursing education programs
Divisional Policy Manual Revised: 6/92, 7/94, 5/95, 4/98, 2/01, 10/03, 1/04,
Written: September, 1991 Policy: Reviewed: 4/01 Divisional Policy Manual Revised: 6/92, 7/94, 5/95, 4/98, 2/01, 10/03, 1/04, Ambulatory Care Division 9/06, 5/09, 10/12 LSU Health Sciences Center-Shreveport,
Monitor Staffing Standards in the Child and Adult Care Food Program Interim Rule Guidance
[ X] Information July 22, 2003 TO: RE: Sponsors of Family Day Care Homes Monitor Staffing Standards in the Child and Adult Care Food Program Interim Rule Guidance The following information we received
FY 2014 Inpatient Prospective Payment System Proposed Rule
FY 2014 Inpatient Prospective Payment System Proposed Rule Summary of Provisions Potentially Impacting EPs On April 26, 2013, the Centers for Medicare and Medicaid Services (CMS) released its Fiscal Year
Missed Nursing Care: Errors of Omission
Missed Nursing Care: Errors of Omission Beatrice Kalisch, PhD, RN, FAAN Titus Professor of Nursing and Chair University of Michigan Nursing Business and Health Systems Presented at the NDNQI annual meeting
IN SEPTEMBER 2010, PETER I.
Kathy Douglas Karlene M. Kerfoot A Provocative Conversation With Peter I. Buerhaus, PhD, RN, FAAN IN SEPTEMBER 2010, PETER I. Buerhaus, PhD, RN, FAAN, was named chair of the National Health Care Work -
Technology s Role in Support of Optimal Perinatal Staffing. Objectives 4/16/2013
Technology s Role in Support of Optimal Perinatal Cathy Ivory, PhD, RNC-OB April, 2013 4/16/2013 2012 Association of Women s Health, Obstetric and Neonatal s 1 Objectives Discuss challenges related to
The Role of The Hospitalist
PHYSICIANS The Role of The Hospitalist By MARIE ROHDE Robert M. Wachter, MD, jokes that if he had trademarked the term hospitalist 18 years ago when he coined it, I d be on my yacht today. Hospital medicine
The Core Elements of Antibiotic Stewardship with CMS and QAPI Updates
The Core Elements of Antibiotic Stewardship with CMS and QAPI Updates Emily Lutterloh, MD, MPH Director, Bureau of Healthcare Associated Infections New York State Department of Health February 8, 2017
5/1/2017 THE BEST DEFENSE IS A GOOD OFFENSE OBJECTIVES. Preparing for a Home Health Medicare Recertification Survey
THE BEST DEFENSE IS A GOOD OFFENSE Preparing for a Home Health Medicare Recertification Survey OBJECTIVES To gain an understanding how the Medicare Conditions of Participation (CoPs), the individual G-tags,
About the Report. Cardiac Surgery in Pennsylvania
Cardiac Surgery in Pennsylvania This report presents outcomes for the 29,578 adult patients who underwent coronary artery bypass graft (CABG) surgery and/or heart valve surgery between January 1, 2014
Improving Nursing Home Compare for Consumers. Five-Star Quality Rating System
Improving Nursing Home Compare for Consumers Five-Star Quality Rating System Improving Nursing Home Compare Major Revision to Nursing Home Compare Mid-December Improved Navigation - Similar to Hospital
Nursing Homes Private Investment Home Deficiencies
Nursing Homes Private Investment Home Deficiencies Highlights of GAO-11-571, a report to congressional requesters July 2011 NURSING HOMES Private Investment Homes Sometimes Differed from Others in Deficiencies,
Patient to Nurse Ratios and Safety Outcomes for Patients
Regis University epublications at Regis University All Regis University Theses Fall 2008 Patient to Nurse Ratios and Safety Outcomes for Patients Julie RinaldiFuller Regis University Follow this and additional
IOWA. Downloaded January 2011
IOWA Downloaded January 2011 481 58.4(135C) GENERAL REQUIREMENTS. 58.4(1) The license shall be displayed in a conspicuous place in the facility which is viewed by the public. 58.4(2) The license shall
STRATEGIES AND SOLUTIONS FOR REDUCING INAPPROPRIATE READMISSIONS
WHITE PAPER STRATEGIES AND SOLUTIONS FOR REDUCING INAPPROPRIATE READMISSIONS This paper offers a two-pronged approach to lower readmission rates and avoid Federal penalties. Jasen W. Gundersen, M.D., M.B.A.,
Statewide and National Impact of California s Staffing Law on Pediatric Cardiac Surgery Outcomes
JONA Volume 41, Number 5, pp 218-225 Copyright B 2011 Wolters Kluwer Health Lippincott Williams & Wilkins THE JOURNAL OF NURSING ADMINISTRATION Statewide and National Impact of California s Staffing Law