Continuing Education » Special Reports » Optimize Your Use of Observation Services: A Guidebook to Successful Practices in Classifying Patients - PDF & CE Exam
Optimize Your Use of Observation Services: A Guidebook to Successful Practices in Classifying Patients - PDF & CE Exam
ISBN:
Publisher: Dorland Health
Published: September 2011
Format:
Product Details
Please Note:
This is an eLearning course approved for 4.0 CE credits. In order to download the report, take the exam, and earn credit you will have to login to our online elearning platform at www.ceu.dorlandhealth.com. You will receive a user name and detailed instructions with your purchase confirmation email.
Observation services, as defined by the Agency for Healthcare Research and Quality (AHRQ) “is an administrative classification of patients seen in hospital emergency rooms or outpatient clinics who have unstable or uncertain conditions potentially serious enough to warrant close observation, but usually not so serious to warrant admission to the hospital.”
Despite this seemingly perspicuous definition, observation is far from clear cut. “The designation of ‘observation status’ patients by hospitals is not well understood and has the potential to distort traditional measures of inpatient hospital utilization,” concludes AHRQ.
With RAC audits now investigating terms of medical necessity involved in decisions about observation, hospitals, rehabilitation centers and other facilities are at stake for major financial liability due to erroneous coding and reporting, as well as subpar patient care based on inappropriate resource utilization.
The goal of this report is to provide frontline practitioners with background information, experts’ insight and real-life examples to make observation services as nondistorted as possible, to protect your financial well-being with workflow solutions, and to enhance the day-to-day operations of your facility.
Table of Contents
Section 1: Introduction and Key Terms
This section provides a comprehensive overview of federal guidelines, national defintions, recent position statements and some of the most-asked questions about observation services.
By Richard Scott
Section 2: What Is Observation
Amid the confusion about changes to CMS policy, there now exist new and emerging opportunities for case managers to make a difference within their facilities.
By Susan Plough, MSN, APRN, BC, CCM
Section 3: Inpatient vs. Outpatient Levels of Care
The error-free care that patients expect from their providers begins at the very first interaction, when the physician determines the appropriate level of care, with the help of case management staff.
By Deirdre Hodges, RN, CCM
Section 4: Observation Services: Getting It Right
Hospitals can incur heavy expenses for incorrect status designation. The right process measures can help keep a facility’s money where it belongs: in their pockets.
By Marcia Colone, PHD, ACM
Section 5: 5 Surefire Strategies for Capturing Appropriate Observation Service
As with most compliance efforts, the more strategic checks and balances in place the better. This section presents five compliance-promoting workflow measures aimed to boost your operating prowess.
By Demetra Reid, RN-BC, BSN, MSHA, CCM
Section 6: Observation Service: Uncomplicating the Complicated
Examples and case studies highlight how facilities can maximize revenue capture from setting the correct designation status.
By Nadene R. Taniguchi, RN, CCM, PAHM
Section 7: Observation and the Importance of Patient Understanding
Enhancing patient satisfaction is vital to any organization, and it is of particular importance in the area of patient status, where provers’ decisions can cause out-of-pocket fees to greatly fluctuate.
By Marilyn Dunne, RN, MS, CNAA, BC
Section 8: Conditions of Observation: What the Patient Should Know
A step-by-step workflow and a “conditions of observation” letter are two ways facilities can improve the awareness levels of their clients.
By Harry D. Kallipolitis, RN, BSN
Number of Page: 50
Format: Available in Downloadable PDF
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