AMA Issues 5 Patient Safety Guidelines

The American Medical Association's five guidelines outline physician responsibilities during care transitions for patients recently discharged from the hospital.

4 comments on "AMA Issues 5 Patient Safety Guidelines"
Susanne Cookson (2/19/2013 at 3:54 PM)

In Canada we are pilot for CHF patients testing a patient education portal designed to provide a step-wise approach to providing education needed for patients to take personal ownership and control after they are discharged from hospital. The program provides education and health trackers for Congestive Heart Failure patients. It provides clear direction in terms of when to call the hospital, what to expect and norms, etc. the site records medication adherence through a meds reminder system. To ensure people use it, there is a rewards points system whereby patients earn points for engaging in the materials, answer comprehension questions, and using the tracker and medication reminders. Aggregate data is provided back to the hospital. The goal is to ensure that patients are well-informed post discharge and equipped to manage their condition.
John Fraser, MD (2/13/2013 at 11:55 AM)

This did not happen as often before healthcare became so compartmentalized. There was a time when physicians admitted most patients from their offices or the ED, managed their inpatient care, then resumed outpatient follow up care. The various handoffs these days increase the risk of important information not being transferred, not to mention multiple providers at different times not noticing subtle changes in the patient's condition.
Natalie Osborne (2/13/2013 at 8:33 AM)

As a nurse manager in a SNF, I have far too many times needed to send a patient back to the hospital because they are too unstable. If patients were stable when they left the hospital, I doubt we would see so many readmissions. It would also be beneficial for the patient coming to the SNF to be formally admitted to the hospital so they may receive the Medicare A benefit. So many patients come to the SNF and think "well, I was in the hospital, I had to be admitted" and that is not the case. Many times they are in observation only and if they are in observation for 3 nights, they will not receive the Medicare benefit.
DHarris RN (2/12/2013 at 1:58 PM)

I hope that PA's and Nurse Practitioners are also able to be reimbursed for coordination of care services. This is a forte of Nurse Practitioners. It is also something that nurses constantly do, wether in the hospital, providing home health care or in ambulatory settings. As a former VNA nurse, I constantly interfaced with community resources and the patient's providers. Many times I admitted a patient to home care only to have to immediately coordinate with the hospital & primary care provider/specialists, or call the hospital to have the patient re-admitted. Nurses are often the coordinating point between other disciplines such as PT, OT, MSW's, behavioral helath specialists etc. This is true in any setting, hospital, ambulatory care & home health. IT can sometimes take hours & hours to make sure resources are connected up with the patient. sometimes it takes daily persistent effort. Please give credit due to the role that nurses play in in coordinations of care throughout the health care system. And by all means, physicians should also be reimbursed for time & effort they make in coortdinations of care. However, the financial future of health care will increasingly need more NP & PA's to stay afloat. They too should receive higher reimbursement for coordination of care and extensive health education & counseling. (On average 3-5x more yet saleries are not comiserate.)


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