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  2. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    The Case Management process encompasses communication and facilitates care along a continuum through effective resource coordination. The goals of Case Management include the achievement of optimal health, access to care and appropriate utilization of resources, balanced with the patient's right to self determination.

  3. Emergency Severity Index - Wikipedia

    en.wikipedia.org/wiki/Emergency_Severity_Index

    Cardiac-related chest pain Asthma attack Altered mental status. 3 Stable, with multiple types of resources needed to investigate or treat (such as lab tests plus diagnostic imaging) Abdominal pain High fever with cough Persistent headache 4 Stable, with only one type of resource anticipated (such as only an x-ray, or only sutures) Simple laceration

  4. Unnecessary health care - Wikipedia

    en.wikipedia.org/wiki/Unnecessary_health_care

    Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. [1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.

  5. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  6. Triage - Wikipedia

    en.wikipedia.org/wiki/Triage

    An example of this would be categorizing a Priority 1 (Immediate) patient as a Priority 2 (Delayed) or Priority 3 (Minimal). The rate of undertriage generally varies by the location of the triage, with a 2014 review of triage practices in emergency rooms finding that in-hospital undertriaging occurred 34% of the time in the United States, [ 7 ...

  7. Sentinel event - Wikipedia

    en.wikipedia.org/wiki/Sentinel_event

    A sentinel event is "any unanticipated event in a healthcare setting that results in death or serious physical or psychological injury to a patient, not related to the natural course of the patient's illness". [1] Sentinel events can be caused by major mistakes and negligence on the part of a healthcare provider, and are closely investigated by ...

  8. Healthcare Cost and Utilization Project - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Cost_and...

    The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  9. Never event - Wikipedia

    en.wikipedia.org/wiki/Never_event

    NHS England produced a report on 148 reported never events in the period from April to September 2013 highlighting particular hospitals with more than one such event. [6] In 2021 there were still about 500 never events each year in the English NHS. According to Jeremy Hunt a hospital can get as many as 108 safety related instructions in a year. [7]