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The Department of Health (Department) is charged with overseeing health care services and facilities to ensure access to high quality care and encouraging innovation and continuous development of improved methods of health care in the Commonwealth. In carrying out these duties, the Department continues to monitor advancements in technology and care models to support an effective and efficient health care system. To that end, the Department has been reviewing innovative hospital models as a viable alternative for hospitals and is pleased to offer the following streamlined options for implementation of new and updated innovative models for eligible hospitals: micro-hospitals (updated); tele-emergency department; and outpatient emergency department.

Below are brief descriptions of each model. Details on the eligibility criteria can be found in the guidance document for the model, with supplemental information available in the FAQ and matrix.

A micro-hospital refers to an acute care hospital that offers emergency services and maintains facilities for at least ten inpatient beds with a narrow scope of inpatient acute care services, such as no surgical services. Formerly known as the "innovative hospital model," this model has proven to be a viable alternative to many facilities and will continue to be an option for providers seeking to offer acute care services in a smaller footprint.

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Tele-ED refers to the operation of a tele-ED staffed by Advanced Practice Providers (APP) 24 hours per day/7 days per week (24/7) with a physician available at all times through telecommunications but not physically present in the emergency department. The Department is making available a structured exception request for eligible low-volume rural hospitals to operate a tele-ED.

The organization of nurses' work is a major determinant of patient and staff welfare. Magnet hospitals have demonstrated organizational attributes that enable nurses to fully use their knowledge and expertise to provide high-quality patient care. The empirical evidence that this type of organization produces better patient and staff outcomes is compelling. Therefore when reconfiguring the delivery of care, the organizational form found in the magnet hospitals should shape systems to promote desired outcomes.

Background: An increasing number of hospitals react to recent demographic, epidemiological and managerial challenges moving from a traditional organizational model to a Patient-Centered (PC) hospital model. Although the theoretical managerial literature on the PC hospital model is vast, quantitative evaluations of the performance of hospitals that moved from the traditional to the PC organizational structure is scarce. However, quantitative analysis of effects of managerial changes is important and can provide additional argument in support of innovation.

Methods: We take advantage of a quasi-experimental setting and of a unique administrative data set on the population of hospital discharge charts (HDCs) over a period of 9 years of Lombardy, the richest and one of the most populated region of Italy. During this period three important hospitals switched to the PC model in 2010, whereas all the others remained with the functional organizational model. This allowed us to develop a difference-in-difference analysis of some selected measures of efficiency and effectiveness for PC hospitals focusing on the "between-variability" of the 25 major diagnostic categories (MDCs) in each hospital and estimating a difference-in-difference model.

Results: We contribute to the literature that addresses the evaluation of healthcare and hospital change by providing a quantitative estimation of efficiency and effectiveness changes following to the implementation of the PC hospital model. Results show that both efficiency and effectiveness have significantly increased in the average MDC of PC hospitals, thus confirming the need for policy makers to invest in new organizational models close to the principles of PC hospital structures.

Conclusions: Although an organizational change towards the PC model can be a costly process, implying a rebalancing of responsibilities and power among hospital personnel (e.g. medical and nursing staff), our results suggest that changing towards a PC model can be worthwhile in terms of both efficacy and efficiency. This evidence can be used to inform and sustain hospital managers and policy makers in their hospital design efforts and to communicate the innovation advantages within the hospital organizations, among the personnel and in the public debate.

Families never receive a bill from St. Jude for treatment, travel, housing or food. Although we accept insurance, St. Jude is a research hospital, so many of the treatment and services we provide are not covered by insurance.

Treatments developed at St. Jude have helped push the overall survival rate for childhood cancer from 20% when the hospital opened in 1962 to more than 80% today. In addition, St. Jude has achieved a 94% survival rate for ALL. The survival rate for ALL was only 4% when St. Jude opened in 1962. The survival rate for medulloblastoma, a type of brain tumor, is 85% today for average risk disease.

The American Nurses Credentialing Center (ANCC) is pleased to present the next generation model for its esteemed Magnet Recognition Program. This new model is designed to provide a framework for nursing practice and research in the future, as well as serving as a roadmap for organizations seeking to achieve Magnet recognition.

ANCC commissioned a statistical analysis of Magnet appraisal team scores from evaluations conducted using the 2005 Magnet Recognition Program Application Manual. This analysis clustered the sources of evidence into more than 30 groups. These groups of sources of evidence yielded an empirical model for the Magnet Recognition Program.

To provide greater clarity and direction, as well as eliminate redundancy within the Forces of Magnetism, the new model configures the 14 Forces of Magnetism into 5 Model Components. The new, simpler model reflects a greater focus on measuring outcomes and allows for more streamlined documentation, while retaining the 14 Forces as foundational to the program.

Strong leadership, empowered professionals, and exemplary practice are essential building blocks for Magnet-recognized organizations, but they are not the final goals. Magnet organizations have an ethical and professional responsibility to contribute to patient care, the organization, and the profession in terms of new knowledge, innovations, and improvements. Our current systems and practices need to be redesigned and redefined if we are to be successful in the future. This Component includes new models of care, application of existing evidence, new evidence, and visible contributions to the science of nursing.

The team measured the total direct cost of care, including costs for nonphysician labor, supplies, medications, and diagnostic tests. They found that for patients who received care at home, total costs were 38 percent lower than for control patients. Home hospital patients had fewer lab orders, used less imaging and had fewer consultations. The team also found that home hospital patients spent a smaller portion of the day sedentary or lying down and had lower readmission rates within 30 days than control patients. Because of the strength of its positive findings, the study was stopped early.

Levine notes that payment remains a challenge for the home hospital model, in part because most insurance companies do not yet recognize the home as a place where hospital-level care happens, although the Brigham is making headway with insurers. With the conclusion of the trial, the Brigham is now increasing home hospital capacity to make it clinically available to more patients.

In our model, expert practice is achieved through the combined influence of nursing practice, organizational supports, and patient and family interactions. The components of these three tenets support learning, discovery, creativity and recognition. All aspects of a magnetized environment.

In January 2023 the Rural Emergency Hospital (REH) model launches, becoming the first new Medicare rural provider type in over 25 years. Congress developed the REH program to keep financially strained rural hospitals from closing and help them better align their services with the evolving needs of their communities. Specifically, the new REH designation will allow communities to transform inpatient hospitals into emergency and outpatient care facilities and adjust payment incentives to reflect a widespread shift from traditional inpatient services to outpatient settings.

Today, one in five Americans lives in a rural community where access to local and convenient health services is far from a given. Rural residents on average travel twice as far as their urban counterparts to receive health care services. And with the closure of 138 rural hospitals over the last 10 years, the situation for many has only worsened.

Of the hospitals that have kept their doors open, many have had been forced to cut important services such as obstetrics units. While rural hospitals benefited from federal financial assistance during the COVID-19 pandemic, early evidence shows that many rural hospitals will struggle again to make ends meet when the federal relief ends, making the success of the new Rural Emergency Hospital model critical.

Rural health care has long centered on inpatient hospital services. However, the need for inpatient care has diminished as medical advancements and innovations have allowed many common procedures to shift to the outpatient setting. For example, certain invasive and therapeutic surgeries that providers used to perform primarily in inpatient settings, such as cataract surgery or certain knee and hernia repairs, now commonly take place in ambulatory settings where patients are in and out the same day. 006ab0faaa