Budget cuts

The House of Representatives approved a Federal budget for fiscal 1997. The budget calls for cutting $1.5 billion from the current $23 billion budget for the Department of Health and Human Services (DHHS). Only half of the DHHS money goes to the National Institutes of Health, whose research programs were expected to remain intact. DHHS programs, such as the Ryan White CARE Act and prevention programs run by the Centers for Disease Control and Prevention (CDC) are likely to bear the brunt of the cuts. The House Veterans Affairs/Housing and Urban Development appropriations bill will be reviewed during the week of June 3, 1996. The Senate envisions a $1.5 billion reduction in DHHS programs, although the action is not final.     

Re-engineered discharge cuts readmissions

By re-engineering its discharge process, North Broward Medical Center in Deerfield Beach, FL, reduced the number of readmissions within 30 days from 29% to 15%. A multidisciplinary team determined that many patients were readmitted because they didn't understand their disease or why they should follow their treatment plan. All clinicians were taught the teach-back method and now encourage patients to ask questions about their condition and treatment plan. The night shift nurses go over the discharge plan the night before patients are discharged and make sure the patients have everything they need, such as food and support, at home. Case managers and pharmacists call patients after discharge to ensure they have a follow-up appointment and answer questions about their treatment plan.