Download or read book MSWCare Transitions in Case Management written by Bonnie Geld and published by . This book was released on 2018 with total page 162 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book CMSA s Integrated Case Management written by Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN and published by Springer Publishing Company. This book was released on 2018-01-28 with total page 316 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by case managers for case managers, this reference manual for nurses and other health professionals presents a CMSA tested approach towards systematically integrating physical and mental health case management principles and assessment tools. Since the health care field has undergone major changes such as the passing of the Patient Protection and Affordable Care Act, Mental Health Parity, Transition of Care & Chronic Care Management and the Medicare Act and CHIP Authorization Act (MACRA), health care workers must competently know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. CMSA’s Integrated Case Management delves into the role of the case manager and unpacks how case managers assess and treat complex patients. These are patients who may be challenged with medical and behavioral conditions, poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, digital and telemedicine, and new performance measures that are clearly defined for nurses in nursing terminology, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach. All content aligns with the newly revised 2017 Model Care Act, CMSA Standards of Practice 2016 as well as the CMSA Core Curriculum for Case Management Third Edition.
Download or read book Advances in Patient Safety written by Kerm Henriksen and published by . This book was released on 2005 with total page 526 pages. Available in PDF, EPUB and Kindle. Book excerpt: v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Download or read book Social Work Case Management written by Michael J. Holosko and published by SAGE Publications. This book was released on 2017-01-30 with total page 520 pages. Available in PDF, EPUB and Kindle. Book excerpt: Social Work Case Management: Case Studies From the Frontlines by Michael J. Holosko is an innovative book that equips readers with the knowledge and skills they need to be effective case management practitioners in a variety of health and human service organizations. A must-read for students and professionals in social work, this important work introduces a unique Task-Centered Case Management Model built around the unifying principles of the profession—person-in-environment, strengths-based work, and ecological perspective. Over twenty case studies by case managers and professionals offer innovative practice insights, illustrating the practice roles and responsibilities of today's case managers and the realities of conducting case management in today’s growing, exciting, and challenging field.
Download or read book Case Management Models Second Edition written by Karen Zander and published by Hcpro, a Division of Simplify Compliance. This book was released on 2017-06-28 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Explains the differences between case management and social work and the ways in which case management functions have evolved over time. Case management is continuously evolving to meet the needs of patients and manage the quality, financial, and legal risks health care systems and accountable care organizations (ACO) face.
Download or read book The Hospital Case Management Orientation Manual written by Peggy Rossi, Bsn, Mpa, CCM and published by Hcpro, a Division of Simplify Compliance. This book was released on 2014-06-12 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Hospital Case Management Orientation Manual Guide is a comprehensive resource that supplements of initial training for new case managers. This book explains what to document, where to document it to ensure appropriate level of care and reimbursement, and how to avoid unnecessary denials. This book's focus is utilization management, discharge planning, and relevant CMS regulations. It can help new case managers learn how to perform their jobs effectively on their own time. It can also serve as a wide-ranging resource for more experienced case managers, particularly those whose training was less than adequate.
Download or read book Social Work Case Management written by Betsy Vourlekis and published by Routledge. This book was released on 2017-07-05 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new practice text provides a series of readings focusing on case management in a number of fields and in a variety of settings with different client populations. Each chapter examines a major component of case management practice by presenting information about an innovative program from a different location around the country. In conjunction, these readings provide a road map to social work case management.In addition to offering up-to-date practice approaches and examining the functions and skills of case management in depth, the authors provide the policy information needed for putting this traditional form of social work practice into today's service delivery context.
Download or read book Nursing Case Management written by Elaine Cohen and published by Elsevier Health Sciences. This book was released on 2004-08-26 with total page 650 pages. Available in PDF, EPUB and Kindle. Book excerpt: This classic resource offers complete coverage of nursing case management - from theoretical background and historical perspective to practical applications and how the field is changing to meet the challenges of today's health care environment. It focuses on the implementation of various case management models used throughout the United States and abroad. Key topics include the impact of public policy on health care; understanding the effects of health care reimbursement and its application at the patient level; throughput and capacity management; the impact of the revenue cycle; compliance and regulatory issues; and principles needed to improve case manager-client interaction. This helpful resource is designed to help nurse case managers assess their organization's readiness for case management, prepare and implement a plan to achieve necessary improvements and evaluate the plan's success. Includes numerous proven case management models currently being used in institutions across the country Organized to take the nursing case manager on a journey from the historical development of nursing case management to the successful implementation of a case management program Offers detailed guidance for planning, implementing, and evaluating a case management program Outlines the planning process with information on key topics such as analysis of the organization, the role of the organization's members, selection criteria for new case managers, case management education, credentialing, and partnerships Features guidelines for implementing a case management program with information on ethical issues, technology, compliance, and regulatory issues Addresses the evaluation component of developing and implementing a case management program by presenting information on outcomes, research, documentation, continuous quality improvement, measuring cost effectiveness, care continuum, and evidence-based practice Presents acute care and community based models of case management Highlights the evolution of collaborative models of case management, addressing key elements of joint decision-making, shared accountability, and interdisciplinary systems of care Addresses health care delivery through case management and public policy by presenting current legislative issues and their affect on both health care reimbursement and the application of care at the patient level Presents the insights, experiences, and advice of nursing administrators who have researched and successfully implemented nursing case management programs in various facilities
Download or read book Emergency Department Case Management Second Edition written by Kathleen Walsh and published by . This book was released on 2014-11-14 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition will ensure that ED case management staff have a solid and sustainable foundation in place. After exploring models and reviewing emergency department infrastructure, this compendium will help readers outline key partnerships, present multiple options for case finding, tackle observation status accurately, address quality and evaluation issues, and identify ways ED RN case managers and social workers coordinate care for complex cases, such as pediatric, psychiatric, homeless, and uninsured populations. In addition to many new tools, this book is also packed with more than 20 detailed spotlights and case studies discussing ED case management strategies, best practices, and experiences of ED professionals from across the country. The new edition includes: The presence of case management RNs and Social Workers in emergency departments (ED) has become a standard since the first edition of this text was published in 2007. Ever-expanding and changing regulations for EDs and hospitals have emerged, while best practices have evolved to address these challenges. This new edition discusses these changes and provides updated guidance on running a compliant, effective, and efficient case management team in the ED. It also provides insight on adapting the role of case management based on unique ED patient populations and helps ED case managers stay ahead of the curve by examining what lies ahead in their profession.
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-08-19 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Download or read book Systems Practices for the Care of Socially At Risk Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-05-07 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
Download or read book Case Management written by Arthur J. Frankel and published by Oxford University Press, USA. This book was released on 2019-01-02 with total page 217 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the course of twenty years and across three editions, this text has approached case management as both an art and a science by providing students and practitioners with the basics of case management theory, skills, and applications. This fourth edition, which focuses on both the social work and nursing professions, offers trainers, instructors, and students detailed information about how case management is delivered, major issues encountered in practice, how services are affected by different populations, and the unique skills that are required by case managers in order to be effective. Chapter exercises and numerous case examples help readers practice some of the skills associated with the content offered. Case Management is unique in that it brings together the major professions that conduct case management in the United States. It is focused on skill learning more than on theory, and discusses not only the importance of case management in the current social work and medical milieu, but also the challenges that case managers face in helping clients. In addition, the text offers a model for integrated case management between professions and in numerous settings, including nursing centers, community mental health facilities, and criminal justice centers.
Download or read book Case Management written by Suzanne K. Powell and published by Lippincott Williams & Wilkins. This book was released on 2018-02-26 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management
Download or read book Core Skills for Hospital Case Managers written by Tony Cesta and published by HC Pro, Inc.. This book was released on 2009-06 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes Toni Cesta, PhD, RN, FAAN; Beverly Cunningham, MS, RN As of June 20, 2014, contact hours for nurses are no longer available with this product. Finally--an affordable, effective, and consistent training program for your hospital case managers. This one-of-a-kind guide to fundamental case management responsibilities is a necessary reference tool for every hospital case management department. This resource is designed to give case management directors and hospital leaders the tools they need to build and strengthen the basic and advanced skills their case management staff needs to succeed. Core Skills for Hospital Case Managers is an orientation and training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to develop and maintain a wide variety of care management skills. Table of contents Chapter 1: Hospital Case Management 101 Chapter 2: Case Manager Role Chapter 3: Roles, Functions, and Caseloads Chapter 4: The Case Management Process Chapter 5: The Case Manager's Role in Transitional and Discharge Planning Chapter 6: Utilization Management Chapter 7: Managing Long Length of Stay Patients Chapter 8: Denials: Prevention and Appeals Strategies Chapter 9: Reimbursement Chapter 10: The Role of the Case Manager in Patient Flow Chapter 11: Measuring Success: Strategic Outcome Measures Chapter 12: Dealing with the Uninsured and Underinsured Chapter 13: Working with Multidisciplinary Teams Chapter 14: Crucial Communication and Conflict Resolution Learning objectives: Discuss the evolution of hospital case management Explain the different models of hospital case management Determine the various goals of hospital case management Examine the various roles of case management Discuss the variety of functions performed by case managers Discuss the scope of the case manager position Examine staffing ratios in various models List the steps in the case management process Determine the role of case managers in documentation Examine case managers' role in discharge planning List the factors that influence the discharge planning process Determine strategies for improving discharge planning Discuss how hospital reimbursement affects utilization management (UM) List the stages of UM coordination Determine the affect of outside influences on UM Evaluate different payers' regulations regarding UM Examine case management's role in length of stay (LOS) Evaluate strategies for managing patients with long LOS Identify data used to track and trend LOS Evaluate the reasons behind denials Discuss case management's role in preventing denials Examine case management's roles in reversing denials Examine case management's role in reimbursement Determine strategies for effective case management related to reimbursement Evaluate case management's role in patient flow Discuss demand and capacity management Identify strategies for managing patient flow Identify measurable case management outcomes Explain how case managers can track quality outcome metrics Discuss other metrics case management departments can track and trend Examine ways to create a case management report card Discuss the unfunded or underfunded patient populations Describe the role of the ED case manager with unfunded or underfunded patient populations Evaluate strategies for dealing with unfunded or underfunded patient populations Examine strategies for successfully working with multidisciplinary teams Describe sources of conflict with which case managers frequently come in contact Discuss strategies for reducing conflict Intended audience Staff nurses, charge nurses, staff educators, staff development specialists, directors of education, nurse managers, and nurse leaders
Download or read book Foundations of Case Management written by Deanna Cooper Gillingham and published by . This book was released on 2021-10-16 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Comprehensive Hospital Medicine E Book written by Mark V. Williams and published by Elsevier Health Sciences. This book was released on 2007-09-26 with total page 1071 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the exciting and growing field of hospital medicine, you're as concerned with the efficient management of your unit as you are the effective care of your patients. This title is your ideal new clinical reference on both counts. Nationally recognized experts equip you with practical, actionable guidance on all of the challenges you face every day—making it easier for you to provide optimal care for every patient. State-of-the-art, evidence-based, hospital-focused guidelines on clinical assessment, diagnosis, prognosis, treatment, and discharge/follow-up planning help you to effectively manage all of the key disorders in every body system. 20 chapters focused on peri-operative care assist you in navigating this increasingly important component of hospital medicine practice. Expert advice on systems issues explores how to establish and enhance a hospitalist program, provide leadership, manage patient transitions of care, establish a teamwork model with hospital staff, promote patient safety and staff performance improvement, standardize care, and navigate legal and ethical concerns.
Download or read book Health Care Transition written by Albert C. Hergenroeder and published by Springer. This book was released on 2018-05-03 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.
