Volume 2, Issue 7 |
December 30, 2005 |
OASIS measures are supposed to be designed to quantify how home health agencies perform their duties. Among these measures acute care hospitalization data tell us the percentage of patients who had to be admitted to the hospital. A lower percentage is better. The national average is 28%, Colorado is 24%, our average is 45%. To understand how our patient population influences this outcome, we looked at our 2005 data for answers.
The major cause for re-hospitalization (2 or more times) in our patient pool is diabetes. The second cause is congestive heart failure (CHF). The third cause is Atrial fibrillation. Fractures come next.
Except for fractures, all these diagnosis result in long-term care for the patients. Which means that some re-hospitalizations are inevitable. Because we keep those patients over many re-certifications our outcomes are also being influenced negatively.
When it comes to long-term care, patient compliance with treatment and education of patient, caregivers and family are the most important things you can do to try to reduce re-hospitalizations.
According to a Center for Disease Control and Prevention (CDC) study about hospitalizations due to diabetes or its complications, “the rate of people with diabetes admitted to a hospital for a potentially preventable reason fell 35 percent between 1994 and 2002. And the rate of kidney failure in diabetes patients has fallen about 30 percent since 1996.” Nilka Rios Burrows, a CDC epidemiologist and the study lead investigator says “new medications to control blood sugar and hypertension are the biggest reason behind the drop in diabetes-related kidney failure.” However numbers are still high because more people are diagnosed to day than 10 years ago.
About CHF, doctor Hilleman’s team writes in its 2003 report: “The most important component to successful home healthcare for patients with CHF is the effective communication of instructions to patients prior to hospital discharge. Patient education is critical to long-term heart failure care because patient behaviors regarding medications management, diet, weight control, smoking cessation, exercise, and follow-up care can have a major impact on the course of heart failure.
Comprehensive discharge planning, including post-discharge support, has also been shown to reduce readmission and improve outcomes in older patients with heart failure.”
Reporting patient’s non-compliance is a major step for us to justify our acute care hospitalization numbers. Look for clinical signs, weight variations and blood analysis results. As you already know teaching is key. Let me know if the literature we provide is good enough, and how we can improve. Follow-up with frequent telephone contacts for those patients at risk is also a good way to keep re-hospitalizations in check.
Some studies have resulted in tools that may allow you to determine if a newly admitted patient is more at risk than others for repetitive hospitalizations while in our care. One is “High Risk Screen & Interdisciplinary Referral”. The other is “Assessment of Risk Factors for Hospitalization and Emergent Care.” Do not hesitate to consult these forms.
| Ingredients | |
| Dough: | |
| 1/2 lb. butter, softened | |
| 8 oz. cream cheese, softened | |
| 2 1/2 cup flour | |
| Filling: | |
| 8 oz. cream cheese, softened | |
| 2 cups powered sugar | |
| 1 small container of CoolWhip® | |
| 1/2 cup pineapple pie filing (or canned crushed pineapples mixed with flour or cornstarch for thickening) | |
| Maraschino cherries | |
| Walnuts, chopped (optional) |
| JAN. 7-22 | National Western Stock Show | Denver |
| JAN. 11-14 | Colorado RV Adventure Travel Show | Colorado Convention Center 303-892-6800 |
| JAN. 19-22 | Denver Boat Show | Colorado Convention Center 970-218-5645 |
| JAN. 21 | Winterfest at Rocky Mountain National Park | Estes Park |
| JAN. 25-27 | Progreen Expo | Colorado Convention Center |
| JAN. 26-29 | Denver International Sportsmen’s Expo | Colorado Convention Center 800-545-6100 |
| JAN. 26-29 | 16th Annual International Snow Sculptor Championships | Breckenbridge |
| JAN. 28-29 | World Wellness Weekend | Colorado Convention Center 514-552-1782 |
| FEB. 4-5 | All About Kids Expo | Colorado Convention Center 303-282-5073 |
| FEB. 8-12 | 93rd Annual Winter Carnival | Steamboat Springs |
| FEB. 11-19 | Colorado Garden and Home Show | Colorado Convention Center 303-932-8100 |
| MAR 1-5 | 6th Annual Durango Film Festival | Durango |
“Chocolate truffles anyone? Have one!.”
“No Thanks. I’m going to pay for it later!”
“Weight?”
“No migraine.”
If you are a migraine or other headaches sufferer, you know that some foods will start them. Me, it’s chocolate and yogurts. Some chemicals in them when present in certain quantity will trigger a migraine, a few minutes, or hours later. I don’t get those often fortunately because I know how to avoid them.
If you haven't put a finger on your foods triggers, here is a list of what the National Headache Foundation thinks could be the culprits.
These are just some examples, that are most reported by migraine sufferers, but you may have your own other triggers.
Avoiding these foods may not stop the migraines from reoccurring since they are probably started by a particular chemical or combination of chemicals that you may find in other foods or dishes, but they should lower the reoccurrences.
According to the National Institute of Neurological Disorders and Stoke, “research scientists are unclear about the precise cause of migraine headaches. There seems to be a general agreement, however, that a key element is blood flow changes in the brain. People who get migraine headaches appear to have blood vessels that overreact to various triggers.”