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Clinical Accuracy Spoken Here
COPD Exacerbations Not Fully Understood

The etiology of COPD exacerbations is not fully understood. It is clear that infections and noxious agents are involved. Yet, for one-third of all cases of exacerbation no cause can be found. Studies of the inflammatory changes during an exacerbation of COPD are difficult to perform due to the acuity of patients during an exacerbation. Available evidence suggests an increase in inflammation with recruitment of neutrophils and eosinophils into the airway mucosa and lumen. Once activated, the neutrophils begin to degranulate and release proteinases which cause epithelial damage, reduce the ciliary’s beat frequency, stimulate mucus secretion by goblet cells and increase the permeability of the bronchial mucosa. The combination of these effects leads to the symptoms seen in a COPD exacerbation, mucosal and sub mucosal edema, excess luminal mucous production and bronchoconstriction.  

Athena Forum, COPD: Module B www.athenaforum.com

Risk Assessment: Family History Not Always Reliable

Genetic mutations have been identified as the cause of inherited cancer risk in some cancer-prone families; these mutations are estimated to account for only 5% to 6% of colorectal cancer cases overall. It may seem simple that obtaining a family history will provide the clinician with critical information about genetic risk, but this is not the case. The accuracy of family history data must be taken into account when using family history to assess individual risk in clinical practice and in identifying families appropriate for cancer research. A reported family history may be erroneous. Small family sizes and premature deaths may limit how informative a family history may be. Also, some persons may carry a genetic predisposition to colorectal cancer but do not develop cancer, giving the impression of skipped generations in a family tree.

Athena Forum, CRC: Module A
Excellence in Case Mgmnt

First HCM Professional Obligation: Accountability

Case managers have three professional obligations.The first is accountability. Hospital Case Managers are accountable for their actions, their advice, and their work ethic not only to patients and their families but to their organization, their profession, government agencies and insurance agencies. CCMA recommends that case management accountability be based primarily on direct patient centered outcomes: patient knowledge, patient involvement in care, patient empowerment, patient adherence, and coordination of patient care.
[Reference: Athena Forum, Principles of Case Management, Module A]

In the Headlines . . .

Six National QI Priorities Announced

According to HHS, the national quality improvement strategy establishes six priorities for improving care and population health, including making care safer by reducing harm; engaging patients and family members as partners; promoting preventive care; and working with communities to foster healthy living practices. HHS collaborated with clinicians, patients, payers, community agencies and other stakeholders to develop the strategy.

"The National Quality Strategy is designed to be an evolving guide for the nation as we continue to move forward with efforts to measure and improve health and healthcare quality." HHS said in a news release.

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Utilization Management CE: Please print all of your CE certificates from the Athena Forum UM course prior to 5pm ET March 31, 2011. At that time we will be replacing the current content with a new & improved course layout. The new UM course will award new CE certificates with new tests required. Thank you.

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JSPH & Athena Forum – Partners in Chronic Care

Managing chronic illness is the key to true healthcare reform.

The program prepares leaders to critically analyze, design, implement and evaluate systems to improve chronic illness prevention and care management across various health care settings and populations

For more information about Jefferson’s MS-CCM program, click here. 215-503-5305

The look of confidence
  CM Excellence® Series: 
  » Principles of Case
  » Patient Advocacy
  » Utilization Management
  » Discharge Planning
  » Hospital Revenue Cycle

  Clinical Series: 
  » Asthma
  » Behavioral Health
  » Colorectal Cancer
  » COPD
  » CV Risk: Stroke & MI
  » Diabetes
  » EOL & Palliative
  » GI Disorders
  » Heart Failure
  » Multiple Sclerosis
  » Obesity Management
  » Pain Management
  » Rheumatoid Arthritis
  » Women’s Health



Cathy Wright Cathy Wright, BSN, RN
Clinical Editor
Athena Forum


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