Essay On Erp

HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around

The patient had a sudden onset of lower left quadrant pain and was diagnosed with

They faced challenges from acquiring many companies because during the acquisitions Bombardier inherited the data, processes and systems of each company which created inefficiencies. Systems didn’t communicate with each other resulting in low inventory turns and price inconsistency. This was not productive for Bombardier and was time consuming for the employees. The biggest problem was the low visibility of inventory and the lack of communication between systems. Bombardier had now a global presence but was not organized to maintain growth without changing the vision and processes. Another challenge is resistance to change, this factor can have a huge impact on the new vision and

T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips

Plan: The patient will be admitted, kept NPO, and an appendectomy will be performed by Dr. Rogers in the morning.

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

The RUC will be able to provide treatment to patients suffering from non-life threatening conditions and the most common illness, including pneumonia and flu, fevers, upper respiratory infections, sprains and strains, lacerations, contusion, and also necessary screening test, such as High Blood Pressure, mammogram, diabetes. Since the late 1980s and early 1990s, hospitals have looked to facilities such as RUCs as a means to reduce rate of inappropriate ED utilizations by triaging patients to less acute settings. The ED is not the most appropriate care setting for many patients, such as elderly patients and young children. Non-urgent patients account for well over 10 percent of the average ED’s caseload, and semi-urgent cases account for another

Ann Hayes, age 68, initially was admitted to the hospital for elective surgical repair of an abdominal aortic aneurysm. Her surgery was documented as uneventful. However, complications developed during her 5th postoperative day as a result of a small bowel perforation.

Few days back, the patient had a CABG surgery and was send home under stable conditions. Family member noticed SOB and weakness from the patient and was directed to attend the ED. As they got to the ED, the emergency department nursing staff noticed SOB with pericardial hematoma and immediate drainage was necessary. A chest tube was placed as a treatment option.

Case fatality rate can be as high as 30% for untreated patients. With quick diagnosis and proper treatment fatalities are extremely rare. The most

• Since 1991, anesthetic and surgical techniques have improved, resulting in lower surgical risk for many patients. Concurrent with these changes, the VHA has implemented a rigorous program of surgical attending oversight of the process of care by resident operators, particularly in surgical suites.

Creating a program that uniformly reduces these complications is a significant advancement in quality of care, an improvement to patient health and satisfaction that is rewarded by government payment programs. With this in mind, CSC set out to develop and implement an ERAS pathway consistent enough to allow sustainable compliance regulation but flexible enough to suit a network with academic medical centers and community hospitals. Our goal was to design evidence based practice, reduce length of hospital stay, prevent post-op complications and readmissions, decrease SSI rate and improve financial burden associated with CMS payment programs including Value based purchasing and HAC reduction program. This pathway addressed hurdles of its forbears with a five-pronged approach. First, a systematic review of the literature was conducted to define the essential elements of a successful ERAS pathway and to understand the logistical hurdles faced by past implementation efforts. Second, a “grassroots” pathway was developed through consensus among stakeholders across Partners hospitals. Third, compliance was encouraged through a decision support scheme built directly into the EHR that was updated to reflect ERAS care decisions across providers. Fourth, the Partners Internal Performance Framework (IFP) was leveraged to encourage each site to develop its own sustainable workflow and regulatory body. Fifth, concise and diverse patient education materials were

The patient had a medical history of hypertension, hyperlipidemia, coronary artery disease, myocardial infarction in 2010, COPD, pulmonary embolism, prostate cancer, gastro esophageal reflux disease, and small bowel adhesions. The patient had an echocardiogram six months ago with an ejection fraction of 45%. Individuals with “an EF of 25% to 50% have an intermediate risk for the development of postoperative low cardiac output

The second identified area where the process broke down was when the patient’s family called the hospital to tell them that she was having emesis and severe pain rated nine out of ten. The triage nurse instructed them to take Tylenol and informed them that the physician was unavailable. The physician eventually called back and instructed them to give her one Tylenol and some soup. In this stage, the physician downplayed the concerns and did not consider the possibility of pancreatitis, the most frequent complication after having had an ERCP (Johnson, Haskell, & Barach, 2016, p. 80). The

Multidisciplinary teams must be used to ensure that transition of care measures are completed. Some patient factors that are predictors of readmission due to rebleeding are features of shock at presentation; melena; age > 60 years; associated comorbidities like heart, liver or renal failure; larger ulcer size; stigmata of recent hemorrhage on endoscopy(11). Some factors in care that are predictors of readmission include early discharge within 72 hours for high risk patients, inadequate PPI dosage, insufficient discharge