Assessment of Harm Risk
The concept of 'harm risk' involves two types of harm:
- harm directed toward oneself
- harm directed toward another person.
The Case Manager must be aware of both types, and learn how to appropriately assess and manage patients who are at some level of harm risk. It is critical for the Case Manager to recognize some disorders may have risk for both harm to self and others, and that the two types are not mutually exclusive. Studies of violence and mental illness have shown that people with mental illness who come from violent backgrounds are often violent themselves.
Behavioral Health: Module D, High-Risk Behavior
CRC Rates Dropping
The U.S. incidence of colorectal cancer (CRC) has been dropping by about 1.8% per year, and death rates have dropped 1.8% over the past two decades. Studies show colorectal cancer risk may be affected by the following factors: Folic acid: High doses of folic acid may help decrease CRC risk. Physical activity: Physical inactivity combined with a high fat diet may increase CRC risk. Obesity: In pre-menopausal women, obesity has been linked to increased CRC risk. Smoking: Cigarette smoking has been linked to increased CRC risk.
CRC: Module A, Pathophysiology
|"Are We Doing It Right?"
To measure outcomes, one must consider: Structure (What was achieved?) and Process (How was the outcome achieved?). Outcomes measurement asks "Are we doing it right?" Processes are the standards of care that are developed for patients with a given diagnosis. The hospital's organizational logistics dictate whether those standards can be met timely. These logistics include issues such as days and hours certain departments provide services. HCMs need to collect data to present to hospital administration about any potential revenue loss along with examples of a revenue sparing plan for organizational change.
CMS Launches Hospital VBP
On April 29, 2011 CMS launched the Hospital Value-Based Purchasing program, an initiative which will reward hospitals for the quality of care they provide and help reduce health care costs. The quality measures focus on how closely hospitals follow best practices and how well hospitals enhance patients' care experiences. Measures include:
- Ensure patients who may have had a heart attack receive care within 90 minutes;
- Provide care within a 24-hour window to surgery patients to prevent blood clots;
- Communicate discharge instructions to heart failure patients;
- Ensure hospital facilities are well maintained. [CMS Fact Sheet, April 29, 2011.]
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CM Excellence® Series:
» Principles of Case
» Patient Advocacy
» Utilization Management
» Discharge Planning
» Hospital Revenue Cycle
» Behavioral Health
» Colorectal Cancer
» CV Risk: Stroke & MI
» EOL & Palliative
» GI Disorders
» Heart Failure
» Multiple Sclerosis
» Obesity Management
» Pain Management
» Rheumatoid Arthritis
» Women’s Health
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