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https://www.readbyqxmd.com/read/28719084/defending-a-never-event
#1
John R Shepperd
There are medical mishaps that have been deemed "Never Events" by the Centers for Medicare & Medicaid Services (CMS). This term refers generally to preventable occurrences so egregious that they should never occur. But they do occur. And when they do, litigation often follows. This article focuses on one such Never Event-the operating room fire-with strategies on how to defend it. Information provided in this article was derived from a review of the relevant literature and from the author's personal experience defending lawsuits arising from Never Events, including a jury trial involving a surgeon who was sued for a patient's injuries after a fire erupted in the operating room...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28718382/establishing-clinical-pharmacy-services-with-prescribing-privileges-in-a-federally-qualified-health-center-primary-care-clinic
#2
Jeany K Jun
OBJECTIVES: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic. SETTING: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#3
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28689056/patient-navigation-for-lung-cancer-screening-in-an-urban-safety-net-system-protocol-for-a-pragmatic-randomized-clinical-trial
#4
David E Gerber, Heidi A Hamann, Noel O Santini, Suhny Abbara, Hsienchang Chiu, Molly McGuire, Lisa Quirk, Hong Zhu, Simon J Craddock Lee
The National Lung Screening Trial demonstrated improved lung cancer mortality with annual low-dose computed tomography (CT) screening, leading to lung cancer screening endorsement by the United States Preventive Services Task Force and coverage by the Centers for Medicare and Medicaid. Adherence to annual CT screens in that trial was 95%, which may not be representative of real-world, particularly medically underserved populations. This pragmatic trial will determine the effect of patient-focused, telephone-based patient navigation on adherence to CT-based lung cancer screening in an urban safety-net population...
July 5, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28677991/purpose-in-life-and-positive-health-outcomes-among-older-adults
#5
Shirley Musich, Shaohung S Wang, Sandra Kraemer, Kevin Hawkins, Ellen Wicker
Purpose in life (PIL) is conceptualized as having goals, a sense of direction, and a feeling that there is meaning to present and past life. PIL has been associated with positive health outcomes among older adults, including fewer chronic conditions, less disability, and reduced mortality. The purpose of this study was to estimate the prevalence of PIL among AARP Medicare Supplement insureds, identify associated characteristics, and measure impact on selected health outcomes. In 2016, surveys were sent to a random stratified sample; PIL was measured using a 7-item scale with 5 responses...
July 5, 2017: Population Health Management
https://www.readbyqxmd.com/read/28655370/antibiotic-stewardship-in-long-term-care-a-call-to-action
#6
Caren McHenry Martin
The Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention are focused heavily on curbing the misuse of antibiotics in health care facilities. Regulations governing the management of antibiotics in the nursing facility will likely be changing in the near future, which will put the pharmacist at the forefront of a clinical team that is dedicated to proper antibiotic utilization. Savvy pharmacists are embracing this opportunity to engage long-term care facility staff to improve the care of their residents...
May 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28635549/a-missed-primary-care-appointment-correlates-with-a-subsequent-emergency-department-visit-among-children-with-asthma
#7
Colleen Marie McGovern, Margaret Redmond, Kimberly Arcoleo, David R Stukus
OBJECTIVE: Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits...
March 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28583465/functional-status-is-associated-with-30-day-potentially-preventable-hospital-readmissions-after-inpatient-rehabilitation-among-aged-medicare-fee-for-service-beneficiaries
#8
Addie Middleton, James E Graham, Kenneth J Ottenbacher
OBJECTIVES: To determine the association between patients' functional status at discharge from inpatient rehabilitation and 30-day potentially preventable hospital readmissions. A secondary objective was to examine the conditions resulting in these potentially preventable readmissions. DESIGN: Retrospective cohort study. SETTING: Inpatient rehabilitation facilities submitting claims to Medicare. PARTICIPANTS: National cohort (N=371,846) of inpatient rehabilitation discharges among aged Medicare fee-for-service beneficiaries in 2013 to 2014...
June 3, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28580498/falls-related-drug-use-and-risk-of-falls-among-older-adults-a-study-in-a-us-medicare-population
#9
Shirley Musich, Shaohung S Wang, Joann Ruiz, Kevin Hawkins, Ellen Wicker
BACKGROUND: Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. OBJECTIVE: The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. METHODS: A 10% random sample, insured in AARP(®) Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users...
July 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28575258/examination-of-chronic-smoking-behavior-and-eligibility-for-low-dose-computed-tomography-for-lung-cancer-screening-among-older-chinese-male-smokers
#10
Chien-Ching Li, Alicia K Matthews, XinQi Dong
Background: Low-dose computed tomography lung cancer (LDCT) screening is an effective way to decrease lung cancer mortality. Both Medicare and private insurers offer coverage of LDCT screening to beneficiaries who are at high risk of developing lung cancer. In this study, we examined rates and predictors of chronic smoking behavior and eligibility for coverage of LDCT screening among older Chinese men living in the greater Chicago area. Methods: Data were obtained from the Population Study of Chinese Elderly in Chicago, a population-based survey of community-dwelling, older Chinese adults in the Chicago metropolitan area...
July 1, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28566133/variation-in-screening-mammography-rates-among-medicare-advantage-plans
#11
Andrew B Rosenkrantz, Margaret Fleming, Richard Duszak
PURPOSE: Prior studies have shown higher screening mammography rates for beneficiaries in capitated managed care Medicare Advantage (MA) plans compared with traditional fee-for-service Medicare. The aim of this study was to explore variation in screening mammography rates at the level of MA managed care plans. METHODS: Using the 2016 MA Healthcare Effectiveness Data and Information Set Public Use File, screening mammography rates were identified for all 385 reporting MA plans...
May 27, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28557519/does-medicare-managed-care-reduce-racial-ethnic-disparities-in-diabetes-preventive-care-and-healthcare-expenditures
#12
Elham Mahmoudi, Wassim Tarraf, Brianna L Maroukis, Helen G Levy
OBJECTIVES: Large and persistent racial/ethnic disparities exist in diabetes care. Considering the rapid rate of growth of Medicare Managed Care (MMC) plans among minority populations, our aim was to investigate whether disparities in diabetes management and healthcare expenditures are smaller in MMC versus Medicare fee-for-service (MFFS) plans. We hypothesized that racial/ethnic disparities in diabetes care and in health expenditures would be less pronounced in MMC compared with MFFS plans...
October 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/28546878/effects-of-medicare-coverage-of-a-welcome-to-medicare-visit-on-use-of-preventive-services-among-new-medicare-enrollees
#13
Boon Peng Ng, Gail A Jensen, Heather Fritz
In January 2005, Medicare began covering a one-time initial preventive physical examination (IPPE), also called a "Welcome-to-Medicare" visit, during a beneficiary's first 6 months under Part B. This paper examines the effects of offering Medicare IPPE coverage on the use of mammograms, breast self-exams, Pap smears, prostate cancer screenings, cholesterol screenings, and flu vaccines among beneficiaries new to Part B. We adopt a difference-in-difference estimator and estimate a set of multivariate logit models to quantify the effects of introducing Medicare IPPE coverage on the use of preventive services...
2017: Journal of Aging Research
https://www.readbyqxmd.com/read/28544946/perceived-barriers-to-healthcare-and-receipt-of-recommended-medical-care-among-elderly-medicare-beneficiaries
#14
Jibby E Kurichi, Liliana Pezzin, Joel E Streim, Pui L Kwong, Ling Na, Hillary R Bogner, Dawei Xie, Sean Hennessy
PURPOSE: Many Medicare beneficiaries perceive barriers to receiving healthcare, although the consequences are unknown. Facilitators can aid in the receipt of healthcare services. The objective was to assess the relationship between perceived facilitators and barriers to healthcare and actual receipt of recommended medical care among elderly beneficiaries. METHODS: A cohort study using data from the 2001-2008 entry panels of the Medicare Current Beneficiary Survey that included 24,607 community-dwelling beneficiaries 65 years of age and older...
May 18, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#15
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28528171/accountable-care-organizations-and-the-use-of-cancer-screening
#16
Christian P Meyer, Anna Krasnova, Jesse D Sammon, Stuart R Lipsitz, Joel S Weissman, Maxine Sun, Quoc-Dien Trinh
Cancer preventive services, when used appropriately, result in improved health, better quality of life and decreased costs. For these reasons, cancer preventive services represent important priorities within the Affordable Care Act (ACA). Among the many provisions to improve access to preventive services the ACA introduced Accountable Care Organizations (ACOs) as trajectory to deliver coordinated, high-quality care. In order to evaluate this benchmark, we analyzed (in 2016/Boston) screening prevalence of breast cancer, a recommended screening test according to the United States Preventive Services Task Force (USPSTF), and prostate cancer, for which screening is no longer recommended by the USPSTF, among traditional Medicare beneficiaries and those enrolled in ACOs...
August 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28486935/emergency-department-use-and-barriers-to-wellness-a-survey-of-emergency-department-frequent-users
#17
Lauren E Birmingham, Thaddeus Cochran, Jennifer A Frey, Kirk A Stiffler, Scott T Wilber
BACKGROUND: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted. METHODS: We performed a prospective study of frequent ED users in an adult only, level 1 trauma center with approximately 90,000 visits per year...
May 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28481976/electronically-available-comorbidities-should-be-used-in-surgical-site-infection-risk-adjustment
#18
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Timothy J Lowe, Anthony D Harris
Background: Healthcare-associated infections such as surgical site infections (SSI) are used by Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. Risk adjustment allows a fairer comparison of SSI rates across hospitals. Until 2016, Centers for Disease Control and Prevention (CDC) risk adjustment models for pay-for-performance SSI did not adjust for patient comorbidities. New 2016 CDC models only adjust for body mass index and diabetes. Methods: We performed a multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals...
May 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28479081/identifying-distinct-risk-profiles-to-predict-adverse-events-among-community-dwelling-older-adults
#19
Melissa O'Connor, Alexandra Hanlon, Elizabeth Mauer, Salimah Meghani, Ruth Masterson-Creber, Sherry Marcantonio, Ken Coburn, Janet Van Cleave, Joan Davitt, Barbara Riegel, Kathryn H Bowles, Susan Keim, Sherry A Greenberg, Justine S Sefcik, Maxim Topaz, Dexia Kong, Mary Naylor
Preventing adverse events among chronically ill older adults living in the community is a national health priority. The purpose of this study was to generate distinct risk profiles and compare these profiles in time to: hospitalization, emergency department (ED) visit or death in 371 community-dwelling older adults enrolled in a Medicare demonstration project. Guided by the Behavioral Model of Health Service Use, a secondary analysis was conducted using Latent Class Analysis to generate the risk profiles with Kaplan Meier methodology and log rank statistics to compare risk profiles...
May 4, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28472291/antibiotic-stewardship-in-small-hospitals-barriers-and-potential-solutions
#20
Edward Stenehjem, David Y Hyun, Ed Septimus, Kalvin C Yu, Marc Meyer, Deepa Raj, Arjun Srinivasan
Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. 73% of United States (US) hospitals have < 200 beds. Small hospitals (< 200 beds) have similar rates of antibiotic prescribing compared to large hospitals but the majority of small hospitals lack ASPs that satisfy the Centers for Disease Control and Prevention's (CDC) core elements. All hospitals, regardless of size, are now required to have ASPs by The Joint Commission and the Centers for Medicare and Medicaid Services has proposed a similar requirement...
May 2, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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