Wedding Kurat

One of the critical task that hospitals have to frequently undertake is to transfer a critically ill or unstable patient from one hospital to another. Transfer of such patient are likely to induce various physiological changes, which may adversely affect the health of patient even leading up-to death. Hence, such transfers shall be undertaken with great care and as per evidenced-based guidelines. Following are the key elements and guidelines for safely executing transfer for an unstable patient. Criteria for identifying unstable patients A patient whose physiological status is in fluctuation and for whom emergent treatment and/or surgical intervention are anticipated, is considered as an unstable patient. Hospital should use clinical criteria to identify an unstable patient. Following criteria can be used as reference for developing hospital’s own criteria Patients with one or more of below condition shall be considered as unstable patient Glasgow coma scale <= 14 Pulse < 60

Another micromanagement has demonstrated costs of micromanagement as much as what might be saved. This is of course what CBO indicated a decade ago about such interventions. This time the CMS Comprehensive Primary Care Initiative failed to demonstrate much - in the practices that survive in the US.  "The initiative slowed growth in emergency department visits by 2 percent in CPC practices, relative to comparison practices. However, it did not reduce Medicare spending enough to cover care management fees or appreciably improve physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures." Higher costs without changes in outcomes - this is not value-based. Once again it appears that the personnel used up in micromanagements of costs and of quality could have better been used to address care delivery. Oregon PCMH Saved 240 million but spent over 250 million Words like comprehensive and continuity mean little in primary ca

A large number of activities takes place in a hospital. Accreditation requires that hospital has standardized its systems and process for carrying out all those functions. One of the important requirement for standardization is to document the policies and processes for each function. Accordingly, a hospital requires a large number of documented systems, policies, processes, protocols, criteria etc. Here is a list of all such topics on which a written document must be there, (Also check - How to organize policy and procedure documents ) A.    Documents related to Access, Assessment and Continuity of Care 1.         Registration  and admission of patients (OPD, IPD and Emergency) 2.        Managing patients during non-availability of beds 3.        Transfer-in of the patient to the hospital 4.        Transfer out/referral of unstable patients to another facility 5.        Transfer out/referral of stable patients to another facility 6.        Initial assessment of patients (Out-patients,