ipl-logo

Essay On Congestive Heart Failure

474 Words2 Pages

My current practice setting is primarily based out of the hospital and quality care measures as well as cost analyses are certainly of big concern this day and time. Providers are constantly making sure that all "quality indicators" are present on each and every cardiac consult that is encountered and making sure that the documentation supports the reason why a certain "quality indicator" is not indicated on the individual patient. What I find thought provoking is that although I may discharge a chronic systolic heart failure patient on all the core measure medications and they demonstrated improvement while in the hospital for the 3 to 4 days that they are allowed for that admission, they still bounce right back into the hospital for "congestive …show more content…

One week later(or sooner), the patient comes back to the emergency room for dyspnea. The emergency room admits them to the primary care and then primary care consults cardiology for congestive heart failure. Cardiology reviews chest x ray which reveals "no acute cardiopulmonary process". So, I wonder why did the patient get readmitted for "congestive heart failure"? A BNP level is checked and it is elevated, but less than it was when they were discharged from the hospital? The patient has multiple other possibly differential diagnoses for dyspnea, so why is the patient readmitted for heart failure? The patient also has COPD, tobacco abuse, and weighs over 300 pounds. Is it perhaps patient's cannot be admitted for the diagnosis of tobacco abuse and morbid obesity? Despite extensive counseling, that the patient is not going to stop smoking so therefore, they are not going to be able to afford their medications. This scenario is never ending unfortunately, and although all efforts are being made to ensure quality care measures are in place, it does not really seem to matter. Risk adjustment methods are certainly another ball of wax and ideally those patients that I mentioned above should be penalized for their risk behaviors and not the providers that are trying their hardest not to be "dinged" for a readmission of "congestive

Show More
Related
489 Words | 2 Pages

For example ICD-10 has expanded diagnoses codes from around 14,300 to around 69,000) and so the suggested need for a greater understanding of the logic and relationship affect between ICD-10 codes and current ICD-9-CM contracts and reimbursements means significant change to the status quo. In my experience is that change is feared or at least distrusted. So as I read the article the need for training to both reassure and build confidence seemed the key point. I think if providers can show staff system wide how use of ICD-10 codes will benefit the system and patient care, if the providers can fully integrate ICD-10 codes into the fabric of the organization then in time ICD-10 will become the familiar model to all (including insurers), just another part of daily work probably leading to that same mix of ambivalence. I think the trick is to do exactly what Padarthy suggests, to proactively and methodically integrate ICD-10 across the whole system in a measured and methodical way with due care to the impact on

Read More
194 Words | 1 Pages

The main aim of every study is to find solutions to a certain problem in the society. It is through the understanding of certain challenges in the nursing profession and society in general that long lasting solutions can be realized. The purpose of this paper is to critically analyze and summarize the results of a qualitative and quantitative peer reviewed articles discussing the issue of hospital readmission and patient education. Qualitative study Congestive Heart Failure (CHF) is a chronic, serious and pricey health condition with a huge medical, social and economic impact. Caring for patients with heart failure is not only about treating the disease’s physical symptoms; it involves educational, supportive, emotional, and cooperative care

Read More
349 Words | 2 Pages

1.Congestive Heart Failure also known as (heart failure) is a life threatening condition. Heart Failure is caused when someone has a weak heart. It usually happens when the bodies blood pump to the heart is not pumping blood to the heart correctly.

Read More
1281 Words | 6 Pages

The issue is that it is very difficult to assess the overall competence and voluntariness of a patient. CMA mandates that the protection of physicians is a must; and any change in law must legally protect those physicians who choose to participate from criminal, civil, and disciplinary proceedings. No physician should feel compelled to participate, and patients are free to transfer to another hospital if a physician denies a patients

Read More
565 Words | 3 Pages

Since CMS implemented the Physician Quality Reporting Initiative (now known as the Physician Quality Reporting System (PQRS) under the Tax Relief and Health Care Act of 2006 (TRHCA), there have been several changes in participation sanctions, reporting mechanisms and eligibility for incentives and bonuses. During the first two years, the program was technically a temporary, renewable initiative that sought to improve the quality of both delivery and coordination of care. The initiative became permanent when the Medicare Improvement for Patients and Providers Act (MIPPA, 2008) was enacted. The Centers for Medicare and Medicaid Services (CMS) believes the sanction-based initiative will empower consumers and providers to make better informed decisions

Read More
599 Words | 3 Pages

After reading the case study Mr. X is still smoking and he is overweight. If they were to grant Mr. X’s the heart he will be right back on the list which is why I will give the heart to Ms. Just because your name is listed on the list to receive a heart, does not mean you need the heart A.S.A.P which Mr. X has showed that

Read More
535 Words | 3 Pages

HHS expects 90% of Medicare payments to be directly tied to quality measures by 2018. It is imperative that hospitals, urgent care clinics and frontline providers align their

Read More
688 Words | 3 Pages

Dyspnea is one of the symptom with patient suffering from heart failure and also experience wheezing. ( chronic obstructive pulmonary disease and chronic heart failure. J Am Coll Cardiol 2007; 49:171.). BNP(B-typ Natriuretic peptide) blood test done on her, to check wether she is suffering from heart failure. Mrs.Smith was monitored closely for signs of deterioration and vitals done regularly.

Read More
1057 Words | 5 Pages

Overall, patients are going to be rendered more diagnosis-centered care, with an interdisciplinary look at each case inpatient, as well as outpatient. Patients will be given a work-up and plan for success, no longer as a “quick-fix”, but a long term plan of care to control chronic diseases outside of the acute care setting. Looking at a study from Connecticut, “By revamping the discharge process and working with post-acute providers, UConn Health Center/John Dempsey Hospital, Farrington, CT, reduced thirty-day heart failure readmissions from 25.1% in August 2010 to 17.1% in March 2012. Key initiatives included follow-up appointments within seven days in the hospital heart clinic, revising nursing education, adding automated dietician, social worker, pharmacy, and cardiology consults with the diagnosis order set, and collaborating with the community providers to smooth the transition of care” (“Hospital Initiative”, 2012).

Read More
2095 Words | 9 Pages

There was a 16 year old named Vinny III. He was a good kid and had a pretty nice life with both his parents. Vinny Jr and Rihanna. Vinny III never really gotten into any serious trouble before and he respected his parents. He kept good grades, played 3 sports, and stayed in church.

Read More
608 Words | 3 Pages

After calling for the Charge Nurse and asking for assistance, my racing thoughts slowed down some. I used this moment to notify the provider of the patient’s status and request a visit to the patient’s room. Completing the SBAR with a provider in a moment where the situation was hectic is not something I do very well. My

Read More
393 Words | 2 Pages

Working in a renal/urology medical-surgical unit, it is a challenge for both the nursing staff and nursing administration to have readmissions due to fluid and electrolyte imbalance from patients with ESRD and CHF. In my own experience, patients who have been in and out of the hospital for the past six months to a year are at a higher risk of acquiring nosocomial infections resulting in a weaker immune system to an already compromised one, as well as longer hospital stay. Readmissions from these patients pose as a physical, emotional and financial strain to both patients and/or their families. Additionally, readmissions within 30 days for patients with CHF poses as an additional cost for hospitals as there is reduced Medicare payments for Inpatient

Read More
245 Words | 1 Pages

Given the prevalence and burden of heart failure (HF) in the United States, and the impact the condition has on the individual patient’s life, many approaches for quality improvement (QI) implementation and evaluation have occurred (Stella, 2013). Regulatory organizations, professional associations and academic institutions have partnered repeatedly in creating guidelines and programs focusing on providing evidence-based care, partnering with patients and families and establishing quality care transitions; as a result, several beneficial QI strategies were identified (Gregg, Klingner, Casey, Prasad, & Moscovice, 2012). Before discussing possible methods, the context of “quality improvement” needs to be determined. One direction can be gleaned from the Institute of Medicine (IOM) report, Crossing the quality chasm:A new health system for the 21st century, which describes high quality care along the domains of effectiveness, safety, patient-centeredness, timeliness, efficiency, and equity (2001).

Read More
404 Words | 2 Pages

Continuity of care is an essential determinant of both quality of care and health outcome. Good indicators of continuity of care include likelihood of having regular doctor, and the organization of referral and feedback among providers and the same level of care and between levels of care. Continuity is essential and crucial for guaranteeing coordination of care. Lack of coordination mostly affects people with higher needs for care, such as those with chronic conditions and older people. Given the increasing burden of chronic diseases and the presence of comorbidities a single patient might move from one provide to the next without any coordination, and therefore a high risk of duplicating tests and harmful prescriptions of drugs.

Read More
441 Words | 2 Pages

Hospital readmission is used for several purposes, such as cost control or a correcting measure for length of hospital stay or other outcome. In recent years, there is a great interest in the readmission rate as a representative of quality of hospital care. So, hospital readmission can be viewed as a criteria of poor quality care and have been estimated to cost Medicare that avoidable to spending (1). Despite its use by administering for both quality of health care and cost control, however, the validity of readmission rates as a criteria of quality of hospital care is not evident (17).

Read More

More about Essay On Congestive Heart Failure

Related Topics

Open Document