– The Best Laid Plans and the Ghost of Robert Byrd – Why 2014 DSH Cuts Don’t Make Sense

Earlier this week, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule on Medicaid Disproportionate Share Hospital (DSH) payment cuts. This rule has been long anticipated by NAPH and health wonks across the city – not to mention the hundreds of hospitals affected by these cuts. The DSH cuts – mandated by the Affordable Care Act (ACA) – are scheduled to begin in FY 2014 (i.e., less than five months from now). Please allow me provide a brief history of how we got here according to me, just one participant in the process....

As a nursing leader and recent NAPH fellow, I would like to extend my thanks and appreciation to NAPH for their continued support for nurses and our nursing profession.

As nurses, we are uniquely positioned to transform, lead and strengthen the health care reform agenda.  I’d like to touch on the impact nurses have on assuring quality patient care and start with a story.

The strong and vibrant maple tree that sits on the shoreline between our cabin and the lake protects the island shore from erosion. You can’t see the roots, but you know the strength of this healthy tree is a foundational structure. I think of my organization, Hennepin County Medical Center, and the many people doing important work, the branches being the services we provide, and the diverse colors of the leaves on the tree as the people who make us excel....

After almost 30 years of nursing and a suggestion by someone I dearly respect, I decided to blog for Nurses Week. First, a little history. Truth be told, I was never someone who dreamed of being a nurse as a little girl. It just never entered my mind. I graduated with a dual degree in biology and medical technology and after only 6 months knew I was not happy with my career choice. I knew I liked medicine but needed interaction with patients and the ability to provide care for them. I thought about many options when a friend suggested nursing.

After thinking about it, the profession seemed like the right decision to make, and I decided to begin an accelerated BSN program. I have never once regretted the decision. My nursing experience has included cardiothoracic post op care, ICU, ambulatory care, utilization review, general and orthopedic surgery, ambulatory surgery – and most recently – clinical research....

Delivering quality and innovation in care is the American Nurses Association (ANA) theme for Nurses Week 2013. People do not always think of government as being the source of innovation. My organization is owned and operated by the County of Santa Clara, in the heart of Silicon Valley where innovation is in the air, where people expect you to be creative. 

The Santa Clara Health and Hospital System is focusing on health promotion to reduce the burden of care on the population we serve. We expect an increased need for primary care in 2014 as the newly insured want to gain better access to care and hopefully reduce the need for more expensive care in the ED....

For the first time, in 2011 the Emergency Nurses Association (ENA) selected 20 hospitals to receive the inaugural Lantern Award. I was so excited to learn the University of Kentucky Chandler Hospital Emergency Department was named among the 20. The following year, eight more hospitals received this prestigious award. ENA has been setting standards for emergency nursing care for more than 40 years. This new award is designed to showcase outstanding emergency department (ED) care and serve as a marker for best practice EDs. 

So what is the Lantern Award all about? And why should hospitals try to achieve this recognition? Prior to 2011, ENA had been working for several years on criteria to identify and reward EDs who were exemplary in their performance. The Lantern Award requires EDs to demonstrate a culture of excellence in emergency care....

As health care providers, we are being met with a challenge to provide evidence-based quality care in the most efficient and cost-effective way possible. We are also being faced with a growing population of geriatric patients, as the baby boomers turn 65 at a rate we have never experienced before. Our elderly patients present to the hospital with complex needs that we must be prepared to address in order to continue to provide quality care that is not only efficient and cost-effective, but that also meets the needs of both the patients and their families.

Key leaders at the University of Alabama at Birmingham (UAB) Hospital identified that we needed to be proactive rather than reactive to our increasing number of geriatric patients coming to our hospital for care. UAB Hospital is a 1,157-bed Magnet facility that cares for more than 17,000 geriatric patients per year....

As a nurse executive there are many key challenges and opportunities that we face centered primarily around the Affordable Care Act and health care reform. The advent of value-based payments and the implications of not providing a great patient experience are significant. I believe that delivering the ideal patient experience in an environment of dwindling reimbursements and greater fiscal responsibility will only be accomplished through the development of a committed, patient-centered, high performing multidisciplinary team. In order to meet and conquer these challenges, the role of leadership development is an integral piece of any successful health care executive. 

My developmental journey as a leader illustrates how unexpected life events and self-initiated change can contribute to the development of capabilities far beyond one’s original, cultural or familial parameters and expectations....

Today is the first day of National Nurses Week, an annual celebration that recognizes the value of nursing and educates the public about how registered nurses (RN) can advance innovation and improve the overall health care system.

National Nurses Week runs from May 6 to May 12 annually, starting with RN Recognition Day and ending on the birthday of Florence Nightingale, who founded nursing as a modern profession.

In honor of this week, NAPH will feature a special blog series that includes entries from member hospitals and NAPH staff, who will highlight the important role nurses play in providing high quality care to patients. While this week is a special time to commemorate RNs, NAPH is proud to recognize nurses for the care they provide 365 days per year....

Since the passage of the Patient Protection and Affordable Care Act, provisions are being enacted to increase opportunities for uninsured Americans to obtain insurance coverage. As more provisions of the legislation roll out during the next several years, mechanisms will be put into place to hopefully improve health care for all Americans as well. Nevertheless, increases in the rate of insurance coverage, and reductions in overall health care costs, do not automatically translate into greater accessibility for patients to health care itself. Indeed, vulnerable populations may face significantly greater challenges in accessing health care compared with other U.S. populations.

When we speak of vulnerable populations, we’re describing the socioeconomically disadvantaged, the disabled, racial and ethnic populations, and those marginalized from general societies....

As local hospitals continue to treat the victims of Monday’s double bombings at the Boston marathon, staff and other medical personnel have started to recount the scene after the blasts.

We’ve been closely tracking hospital reports out of Boston, paying particular attention to our member hospital Boston Medical Center (BMC), a Level 1 trauma center that treated 23 victims. Staff from member UMass Memorial Health Care also were stationed at the marathon's medical tent and provided care to victims in the immediate aftermath.

Below you’ll find a list of coverage so far that will be updated as new reports are released.

Our thoughts continue to be with all of the victims, their families, and the hospitals and other providers who are caring for them.

• Executive vice chair of emergency medicine at BMC Dr....