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Collaborative Decision-making Framework
Collaborative Decision-making Framework

...  staffing decisions that take into account the client, the nursing professional and environmental factors;  collaboration, communication and consultation;  role and job descriptions that reflect and respect the scope of practice for each of the three nursing professions;  professional developmen ...
Quality of Health Care in the United States: A Chartbook Sheila Leatherman
Quality of Health Care in the United States: A Chartbook Sheila Leatherman

... United States, with evidence of underuse of beneficial services, overuse of other procedures that are not medically necessary, and mistakes leading to patient injury (IOM 2001a, President’s Advisory Commission 1998). The Institute of Medicine of the National Academy of Sciences has stated, “that the ...
PROVIDER RESOURCE MANUAL  Revised Date:
PROVIDER RESOURCE MANUAL Revised Date:

... GHC-SCW provides coverage for services obtained at a hospital emergency room or an emergency room located at an outpatient facility when the services are necessary to treat an emergency medical condition. GHC-SCW provides ER coverage for patients both in-network and out-of-network. If a member is ex ...
CHOOSING WISELY® IN HEALTH CARE: A CANADIAN
CHOOSING WISELY® IN HEALTH CARE: A CANADIAN

... Most of us have heard about Choosing Wisely® in the United States. It is a very well-regarded program becoming accepted in Canada and implemented in various ways. The program involves provider-led identification of tests and treatments that physicians and patients should question before initiating w ...
Improving Sedation in Intensive Care: New drugs or better methods?
Improving Sedation in Intensive Care: New drugs or better methods?

... there are provisions for stopping or reducing the infusion rate by 25% or 50%, and if agitated a moderately large bolus of midazolam, lorazepam, or fentanyl may be given. However, no quantified definition that would be objectively consistent was available to define these states. More concisely, the ...
Medical Reimbursement Account (MRA) Eligible
Medical Reimbursement Account (MRA) Eligible

... How long will my MRA be available? ...
Infection Prevention and Control Latest Annual Report
Infection Prevention and Control Latest Annual Report

... of all incident cases of MRSA were infections, a decrease from 51% reported during 2013-14. The proportion of new MRSA cases categorized as infections varied between acute care facilities in 2014-15 from a low of zero percent at SPH to a high of 42% at CDH and NRGH. The annual rate for healthcare as ...
Correcting Misconceptions in Mental Health Policy: Strategies for
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... developed in recent years through Medicaid and other public programs. The care of mentally ill persons must be organized to maximize possible trade-offs between inpatient and other community services in a way that will promote function and satisfactory adjustment. An indemnity approach emphasizes co ...
student: dr oluwatoyin aliu odufuwa
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... patients were satisfied with the level of service received at the referral centre. 77% (210) reported that the staff at the referral centre was friendly and 84% (230) were happy with the explanation given for their illness. However, a source of concern is that, in most of the referred patients 58% ( ...
ACTION London GENERAL PRACTICE
ACTION London GENERAL PRACTICE

... Many models and configurations of services will emerge in response to the challenges general practice currently faces. Tweaking at the edges will not be an option – London needs solutions that will sustain primary care for the next 50 years. Changing the divisions between primary and secondary care ...
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... • long-term care. HCWs should recognise that, although specific settings may have their own requirements, the principles outlined in these guidelines form the basis for infection control procedures in all health care settings. Overall, successful infection control depends on: • each health care esta ...
I C A
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... finding quality care by keeping You informed about Your options before You go to the doctor, the hospital, an imaging center, or an emergency room. They can answer Your questions about Plan provisions, treatment choices, cost savings options, community resources and more. Some of the key features, b ...
Teens Who are Coping with a Life-Threatening Illness
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... turbulence that accompany the opening of new horizons toward the future. The presence of lifethreatening illness, whether newly diagnosed in adolescence, or as a pre-existing condition, adds layers of complexity to what is already in flux. In the words of nineteen-year old Katharine, who had been di ...
Cigna begins new relationship with HearPO
Cigna begins new relationship with HearPO

... analog hearing aids and supplies directly from HearPO for their patients with Cigna insured or administered coverage that includes a hearing aid benefit. • Digital and digitally programmable analog hearing aids and supplies that are not ordered from HearPO for these individuals will not be eligibl ...
Home Health Care - UnitedHealthcareOnline.com
Home Health Care - UnitedHealthcareOnline.com

... This Coverage Determination Guideline provides assistance in interpreting UnitedHealthcare benefit plans. When deciding coverage, the member specific benefit plan document must be referenced. The terms of the member specific benefit plan document [e.g., Certificate of Coverage (COC), Schedule of Ben ...
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Awakening and Breathing (AB) - SEDATION
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... Shehabi Y, et al. Crit Care Med. 2010;38(12):2311-2318. Rockwood K, et al. Age Ageing. 1999;28(6):551-556. Jackson JC, et al. Neuropsychol Rev. 2004;14:87-98. Nelson JE, et al. Arch Intern Med. 2006;166:1993-1999. ...
(SIM) Practice Milestone Implementation Guide
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... locations but may collaborate and coordinate care between their two practices by having preferred providers and referral sources and opportunities for communication between the settings (not necessarily about specific patients).  Co-located Care - both types of providers deliver traditional outpati ...
End-of-Life Hospital Care for Cancer Patients
End-of-Life Hospital Care for Cancer Patients

... At the end of life, consideration should be given to ensuring dignity for patients and loved ones and to providing access to palliative care as needed.4 The goal of palliative care is to make people as comfortable as possible by relieving symptoms (such as pain or nausea), improving their quality of ...
2014 MEDICARE PROVIDER MANUAL www.care1st.com/ca/medicare  Care1st Health Plan
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... and other providers to ensure that our Members receive medically necessary and clinically appropriate covered services. We are a managed care delivery system in which the PCPs serve as a “gatekeeper” for Member care. PCPs are responsible for coordinating and overseeing the delivery of services to Me ...
Health Insurance Brochure - The Lawrenceville School
Health Insurance Brochure - The Lawrenceville School

... covered Injury or Sickness. Usual and Customary Charges are based on data provided by FAIR Health, Inc. using the 90th percentile based on location of the provider. Benefits will be paid up to the Maximum Benefit for each service scheduled below. Covered Medical Expenses include: Inpatient Room and ...
Cost and Quality Incentives in Health Care: Altruistic
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... as well as many countries, the majority of providers are nonprofit organizations. In fact, Arrow (1963) more than thirty years ago pointed out that health care providers may be interested in their patients’ welfare, and behave in an altruistic way. The same idea has also been emphasized in Eisenberg ...
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... reducing resource utilization in the surgical intensive care unit. Intensive Care Med. 2001; 27(6):1029-36. Pronovost PJ, Miller MR, Dorman T, Berenholtz SM, Rubin H. Developing and implementing measures of quality of care in the intensive care unit. Curr Opin Crit Care. 2001; 7(4):297-03. Pronovost ...
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The Black Country Sustainability and

... with ever more complex conditions; continuing progress in treatments and medical techniques comes with new costs and expectations; and modern lifestyle issues such as obesity are causing an increase in long term conditions. For the future, we must transform services to adapt to these rising demands. ...
Paramedic Care: Principles & Practice Volume 1
Paramedic Care: Principles & Practice Volume 1

... Parenteral Drug Administration Drug administration outside of the gastrointestinal tract. The parenteral route involves the use of needles as medications are injected into the circulatory system or tissues. Parenteral drug delivery affords the most rapid drug delivery and absorption. ...
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Managed care

The term managed care or managed health care is used in the United States to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care (""managed care techniques""), for organizations that use those techniques or provide them as services to other organizations (""managed care organization"" or ""MCO""), or to describe systems of financing and delivering health care to enrollees organized around managed care techniques and concepts (""managed care delivery systems"")....intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973. While managed care techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has had mixed results in its overall goal of controlling medical costs. Proponents and critics are also sharply divided on managed care's overall impact on the quality of U.S. health care delivery.
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