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The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Represents the vast experience of the world's leading experts in field hospital deployment in disasters and conflicts.
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.
Learn how to detect and prevent the hacking of medical equipment at hospitals and healthcare facilities. A cyber-physical attack on building equipment pales in comparison to the damage a determined hacker can do if he/she gains access to a medical-grade network as a medical-grade network controls the diagnostic, treatment, and life support equipment on which lives depend. News reports inform us how hackers strike hospitals with ransomware that prevents staff from accessing patient records or scheduling appointments. Unfortunately, medical equipment also can be hacked and shut down remotely as a form of extortion. Criminal hackers will not ask for a $500 payment to unlock an MRI, PET or CT scan, or X-ray machine—they will ask for much more. Litigation is bound to follow and the resulting punitive awards will drive up hospital insurance costs and healthcare costs in general. This will undoubtedly result in increased regulations for hospitals and higher costs for compliance. Unless hospitals and other healthcare facilities take the steps necessary to secure their medical-grade networks, they will be targeted for cyber-physical attack, possibly with life-threatening consequences. Cybersecurity for Hospitals and Healthcare Facilities is a wake-up call explaining what hackers can do, why hackers would target a hospital, the way hackers research a target, ways hackers can gain access to a medical-grade network (cyber-attack vectors), and ways hackers hope to monetize their cyber-attack. By understanding and detecting the threats, you can take action now—before your hospital becomes the next victim. What You Will Learn: Determine how vulnerable hospital and healthcare building equipment is to cyber-physical attack Identify possible ways hackers can hack hospital and healthcare facility equipment Recognize the cyber-attack vectors—or paths by which a hacker or cracker can gain access to a computer, a medical-grade network server, or expensive medical equipment in order to deliver a payload or malicious outcome Detect and prevent man-in-the-middle or denial-of-service cyber-attacks Find and prevent hacking of the hospital database and hospital web application Who This Book Is For: Hospital administrators, healthcare professionals, hospital & healthcare facility engineers and building managers, hospital & healthcare facility IT professionals, and HIPAA professionals
Healthcare Organizations offer significant opportunities for change and improvement in their overall performance. Hospitals and clinics are generally large, complex, and inefficient, and need serious development in process workflow and management systems, which will ultimately lead to better patient and financial outcomes. The National Academy of Medicine has stated that hospital systems are broken, and that they must begin by "... improving hospital efficiency and patient flow, and using operational management methods and information technologies." In fact, costs and quality are two of the important aspects of the "triple aim" in healthcare. One area that offers significant potential for improvement is through the application of performance improvement methods to patient and process flows. Performance improvement has a significant impact on a hospital’s over financial and strategic performance. Performance improvement involves the deployment of quantitative and scientific methods to model and influence the functioning of organizations. Performance improvement professionals are tasked with managing a variety of activities, such as deploying new information technologies, serving as project managers for construction events, re-engineering departmental process workflow, eliminating bottlenecks, and improving the flow and movement of patients between resource-intensive clinical areas. All of these are high risk, and require use of advanced, sophisticated methods to improve efficiency and quality, while minimizing disruptions from change. This updated edition is a comprehensive and concise guide to performance improvement in healthcare. It describes the management engineering principles focused on designing optimal management and information systems and processes. Case studies and examples are integrated throughout all chapters.
Hospital Medicine is the fastest growing field of Medicine, and the importance of hospitalists in the delivery of care and success of hospitals continues to increase. The practice of hospital medicine is both rewarding and challenging: hospitalists need to provide high-quality care using the best available evidence in an efficient, cost-effective manner. In recognition of the need for rapid access to essential information, this text provides a concise yet comprehensive source for busy clinicians. The Handbook of Hospital Medicine provides detailed reviews of all clinical topics in inpatient medicine, including common diagnoses, hospital- acquired conditions, medical consultation, and palliative care, as well as key non-clinical topics, such as quality improvement tools, approach to medical errors, the business of medicine, and teaching tips. It is the single source needed for hospitalists striving to deliver outstanding care and provide value to their patients and hospitals.
This book is an implementation manual for lean tools and principles in a healthcare environment. Lean is a growth strategy, a survival strategy, and an improvement strategy. The goal of lean is, first and foremost, to provide value to the patient/customer, and in so doing eliminate the delays, overcrowding, and frustration associated with the existing care delivery system. Lean creates a better working environment where what is supposed to happen does happen. On time, every time. It allows clinicians to spend more of their time caring for patients and improves the quality of care these patients receive. A lean organization values its employees and encourages their involvement in organizational initiatives which, in turn, sustains hospital-wide quality improvements. The opportunities for lean in healthcare are limitless. This is not a book to be read and forgotten, nor is it meant to sit on a book shelf as another addition to an impressive but underutilized collection of how-to books. As the name implies, it is a guide; a companion to be referenced again and again as the organization moves forward with its lean transformation.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.