Quality Of The Case Management Process

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CMSA's Integrated Case Management

Author : Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN
Publisher : Springer Publishing Company
ISBN 13 : 0826169511
Total Pages : 316 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis CMSA's Integrated Case Management by : Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN

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.

Social Work Case Management

Author : Betsy Vourlekis
Publisher : Routledge
ISBN 13 : 135148933X
Total Pages : 164 pages
Book Rating : 4.3/5 (514 download)

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Book Synopsis Social Work Case Management by : Betsy Vourlekis

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 164 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.

Case Management

Author : Suzanne K. Powell
Publisher : Lippincott Williams & Wilkins
ISBN 13 : 1496384261
Total Pages : 914 pages
Book Rating : 4.4/5 (963 download)

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Book Synopsis Case Management by : Suzanne K. Powell

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 914 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

Case Management

Author : Shilpa Ross
Publisher :
ISBN 13 : 9781857176308
Total Pages : 32 pages
Book Rating : 4.1/5 (763 download)

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Book Synopsis Case Management by : Shilpa Ross

Download or read book Case Management written by Shilpa Ross and published by . This book was released on 2011 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Foundations of Case Management

Author : Deanna Cooper Gillingham
Publisher :
ISBN 13 : 9781943889150
Total Pages : pages
Book Rating : 4.8/5 (891 download)

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Book Synopsis Foundations of Case Management by : Deanna Cooper Gillingham

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:

The Integrated Case Management Manual

Author : Roger G. Kathol, MD
Publisher : Springer Publishing Company
ISBN 13 : 082610634X
Total Pages : 319 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis The Integrated Case Management Manual by : Roger G. Kathol, MD

Download or read book The Integrated Case Management Manual written by Roger G. Kathol, MD and published by Springer Publishing Company. This book was released on 2010-06-03 with total page 319 pages. Available in PDF, EPUB and Kindle. Book excerpt: Designated a Doody's Core Title! An ideal reference guide for case managers who work with complex, multimorbid patients, The Integrated Case Management Manual helps readers enhance their ability to work with these patients, learn how to apply new evidence-based assessments, and advocate for improved quality and safe care for all patients. This text encourages case managers to assess patients with both medical and mental health barriers to improvement in order to coordinate appropriate integrated health interventions and treatment planning. Built upon the goals and values of the Case Management Society of America (CMSA), this manual guides case managers through the process of developing new and important cross-disciplinary skills. These skills will allow them to alter the health trajectory of some of the neediest patients in the health care system. Key Features: Tools and resources for deploying an Integrated Health Model (physical and mental health treatment) to the medically complex patient Complexity assessment grids: a color-coded tool for tracking patient progress and outcomes throughout the trajectory of the illness Methods for building collaborative partnerships in emerging models of care delivery within multidisciplinary health care teams Strategies for using an integrated case management approach to improve efficiency, effectiveness, accountability, and positive outcomes in clinical settings Guidance on connecting multi-disciplinary teams to assist with health issues in the biological, psychological, and social domains to overcome treatment resistance, reduce complications, and reduce cost of care

Core Skills for Hospital Case Managers

Author : Tony Cesta
Publisher : HC Pro, Inc.
ISBN 13 : 1601463537
Total Pages : 319 pages
Book Rating : 4.6/5 (14 download)

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Book Synopsis Core Skills for Hospital Case Managers by : Tony Cesta

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

Solution-Focused Case Management

Author : Robert G. Blundo, PhD, LCSW
Publisher : Springer Publishing Company
ISBN 13 : 0826171869
Total Pages : 230 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Solution-Focused Case Management by : Robert G. Blundo, PhD, LCSW

Download or read book Solution-Focused Case Management written by Robert G. Blundo, PhD, LCSW and published by Springer Publishing Company. This book was released on 2015-11-06 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt: “Blundo and Simon have successfully outlined how a solution-focused perspective can be a powerful tool for case managers. Their understanding and presentation is based upon practice scenarios that are real and applied...They clearly demonstrate the impact of ‘thinking and language’ and the importance of building a collaborative relationship with clients. Their work challenges the traditional theory-driven interventions that focus on problems and arrive at a diagnosis . They encourage a ‘shift’ to a co-constructive partnership that requires a practitioner to respect that clients are ‘experts of their own lives’...They provide a clear step-wise discussion of techniques and strategies that can be employed working with individuals and families in case management settings. This book is a must read.” -Lawrence T. Force, PhD. LCSW-R Professor of Psychology, Mount Saint Mary College, Newburgh, NY From the Foreword Solution-focused practice is a paradigm that stresses client abilities, strengths, and individual goals rather than disability. Written by a team of educator/practitioners noted for their expertise in solution-focused therapy, this “how-to” text for social work, counseling, and psychology students guides current and future case managers in learning this strengths-based, collaborative approach to case management. It discusses both the philosophical basis for solution-focused casework and demonstrates how it is ideally suited for the case management process. The book is based on teaching materials the authors have developed and used in their classes and workshops with undergraduate and graduate students and professionals. The text incorporates new research and theoretical developments in solution-focused therapy as well as actual practice scenarios demonstrating the process of building a collaborative relationship with individual clients and families. Replete with strategies and tools for practicing solution-focused case management, the text describes such essential skills as identifying goals, monitoring progress, working with other agencies, and transitioning out of treatment. It discusses issues related to ethical practice and presents strategies for self-care. Additionally, the book addresses diversity and social justice and their relationships to solution-focused practice. Student exercises help to reinforce knowledge. The text will assist case managers in a variety of settings—hospitals, nursing homes, rehabilitation facilities, community-based mental health agencies, schools, prisons, court systems, and shelters for the homeless and victims of domestic violence—to partner with their clients towards finding strengths-based and solution-focused approaches to resolving issues in a positive way. Key Features: Authored by noted experts in solution-focused education and practice Facilitates a reframing of casework and case management around client strengths and resources Provides specific case examples that allow readers to troubleshoot and apply solution-focused principles to practice Includes student exercises throughout the book

The Integrated Case Management Manual

Author : Roger G. Kathol
Publisher : Springer
ISBN 13 : 3319747428
Total Pages : 343 pages
Book Rating : 4.3/5 (197 download)

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Book Synopsis The Integrated Case Management Manual by : Roger G. Kathol

Download or read book The Integrated Case Management Manual written by Roger G. Kathol and published by Springer. This book was released on 2018-06-14 with total page 343 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thoroughly revised and updated since its initial publication in 2010, the second edition of this gold standard guide for case managers again helps readers enhance their ability to work with complex, multimorbid patients, to apply and document evidence-based assessments, and to advocate for improved quality and safe care for all patients. Much has happened since Integrated Case Management (ICM), now Value-Based Integrated Case Management (VB-ICM), was first introduced in the U.S. in 2010. The Integrated Case Management Manual: Valued-Based Assistance to Complex Medical and Behavioral Health Patients, 2nd Edition emphasizes the field has now moved from “complexity assessments” to “outcome achievement” for individuals/patients with health complexity. It also stresses that the next steps in VB-ICM must be to implement a standardized process, which documents, analyzes, and reports the impact of VB-ICM services in removing patient barriers to health improvement, enhancing quality and care coordination, and lowering the financial impact to patients, providers, and employer groups. Written by two expert case managers who have used VB-ICM in their large fully disseminated VB-ICM program and understand its practical deployment and use, the second edition also includes two authors with backgrounds as physician support personnel to case managers working with complex individuals. This edition builds on the consolidation of biopsychosocial and health system case management activities that were emphasized in the first edition. A must-have resource for anyone in the field, The Integrated Case Management Manual: Value-Based Assistance to Complex Medical and Behavioral Health Patients, 2nd Edition is an essential reference for not only case managers but all clinicians and allied personnel concerned with providing state-of-the-art, value-based integrated case management.

Practice of Case Management

Author : David P. Moxley
Publisher : SAGE
ISBN 13 : 9780803932050
Total Pages : 168 pages
Book Rating : 4.9/5 (32 download)

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Book Synopsis Practice of Case Management by : David P. Moxley

Download or read book Practice of Case Management written by David P. Moxley and published by SAGE. This book was released on 1989 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Practice of Case Management in the Human Services offers a succinct yet comprehensive guide to carrying out a case manager's responsibilities. The author explores assessment of the service needs of the client, facilitating the client's contact with the appropriate institutions and services, monitoring the quality of services provided to the client, and taking action when the client's needs are not met. He also considers the therapeutic role required when needs are not met because the problems are indigenous to the client. Providing an integrated look at practice technologies applicable to a variety of practice areas, the volume is appropriate for both preservice and inservice education in the field of human servi

Case Management

Author : Mary Hubbard Linz
Publisher :
ISBN 13 :
Total Pages : 188 pages
Book Rating : 4.E/5 ( download)

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Book Synopsis Case Management by : Mary Hubbard Linz

Download or read book Case Management written by Mary Hubbard Linz and published by . This book was released on 1989 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt:

CMSA Core Curriculum for Case Management

Author : Hussein M. Tahan
Publisher : Lippincott Williams & Wilkins
ISBN 13 : 1496351894
Total Pages : 862 pages
Book Rating : 4.4/5 (963 download)

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Book Synopsis CMSA Core Curriculum for Case Management by : Hussein M. Tahan

Download or read book CMSA Core Curriculum for Case Management written by Hussein M. Tahan and published by Lippincott Williams & Wilkins. This book was released on 2016-07-05 with total page 862 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fully updated CMSA Core Curriculum for Case Management, 3rd edition, is the definitive roadmap to an informed, effective, collaborative case management practice. This comprehensive, expertly-written guide provides those directly or indirectly involved in case management with information about best practices, descriptions of key terms, essential skills, and tools that fulfill the current Case Management Society of America’s (CMSA) standards and requirements. Addressing the full spectrum of healthcare professional roles and environments, this is both a crucial certification study guide and vital clinical resource for the case management professionals in all specialty areas, from students to veteran case managers. This unique resource provides the core knowledge needed for safe, cost-effective case management with the following features ... NEW text boxes highlighting key information and vital practices in each chapter NEW and updated Standards of Practice implications in each chapter NEW and updated content on transitions of care, community-based care, care coordination, Value-Based Purchasing, ethics and social media, the impacts of health care reform, and digital technology NEW and updated content on accreditation in case management NEW chapter that lists key additional resources, by topic Official publication of the Case Management Society of America, connecting CMSA core curriculum to current CMSA Standards of Practice Easy-to-grasp, detailed topical outline format for quick scan of topics Complete, updated core knowledge required of case managers, with expert descriptions and direction on areas including: Case management roles, functions, tools, and processes Plans, clinical pathways, and use of technology Transitional planning Utilization management and resource management Leadership skills and concepts Quality and outcomes management; legal and ethical issues Education, training, and certification Health care insurance, benefits, and reimbursement systems Practice settings and throughput Interdisciplinary teams’ needs in: hospitals, community clinics, private practice, acute care, home care, long-term care and rehab settings, palliative care, and hospice settings Up-to-date guidance on case management specialty practices, including: nursing, life care planning, workers’ compensation, disability management, care of the elderly, behavioral health, transitions of care, subacute and long-term care, utilization review/management, primary care and medical/health home, and more Essential content for academic reference, training, certification study, case management models design, performance or program evaluation

Oracle Case Management Solutions

Author : Léon Smiers
Publisher : CRC Press
ISBN 13 : 1482223848
Total Pages : 454 pages
Book Rating : 4.4/5 (822 download)

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Book Synopsis Oracle Case Management Solutions by : Léon Smiers

Download or read book Oracle Case Management Solutions written by Léon Smiers and published by CRC Press. This book was released on 2015-10-28 with total page 454 pages. Available in PDF, EPUB and Kindle. Book excerpt: Organizations increasingly need to deal with unstructured processes that traditional business process management (BPM) suites are not designed to deal with. High-risk, yet high-value, loan origination or credit approvals, police investigations, and healthcare patient treatment are just a few examples of areas where a level of uncertainty makes outc

Quality of the case management process

Author : Berkeley Planning Associates
Publisher :
ISBN 13 :
Total Pages : 214 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Quality of the case management process by : Berkeley Planning Associates

Download or read book Quality of the case management process written by Berkeley Planning Associates and published by . This book was released on 1977 with total page 214 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Case Management

Author : Arthur J. Frankel
Publisher : Oxford University Press, USA
ISBN 13 : 0190858885
Total Pages : 217 pages
Book Rating : 4.1/5 (98 download)

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Book Synopsis Case Management by : Arthur J. Frankel

Download or read book Case Management written by Arthur J. Frankel and published by Oxford University Press, USA. This book was released on 2019 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.

Health Care Quality Management

Author : Thomas K. Ross
Publisher : John Wiley & Sons
ISBN 13 : 1118505530
Total Pages : 624 pages
Book Rating : 4.1/5 (185 download)

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Book Synopsis Health Care Quality Management by : Thomas K. Ross

Download or read book Health Care Quality Management written by Thomas K. Ross and published by John Wiley & Sons. This book was released on 2014-01-07 with total page 624 pages. Available in PDF, EPUB and Kindle. Book excerpt: In today’s challenging health care environment, health care organizations are faced with improving patient outcomes, redesigning business processes, and executing quality and risk management initiatives. Health Care Quality Management offers an introduction to the field and practice of quality management and reveals the best practices and strategies health care organizations can adopt to improve patient outcomes and program quality. Filled with illustrative case studies that show how business processes can be restructured to achieve improvements in quality, risk reduction, and other key business results and outcomes Clearly demonstrates how to effectively use process analysis tools to identify issues and causes, select corrective actions, and monitor implemented solutions Includes vital information on the use of statistical process control to monitor system performance (variables) and outcomes (attributes) Also contains multiple data sets that can be used to practice the skills and tools discussed and reviews examples of where and how the tools have been applied in health care Provides information on root cause analysis and failure mode effects analysis and offers, as discussion, the clinical tools and applications that are used to improve patient care By emphasizing the tools of statistics and information technology, this book teaches future health care professionals how to identify opportunities for quality improvement and use the tools to make those improvements.

Advanced Case Management

Author : Suzanne K. Powell
Publisher : Lippincott Williams & Wilkins
ISBN 13 : 9780781722346
Total Pages : 358 pages
Book Rating : 4.7/5 (223 download)

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Book Synopsis Advanced Case Management by : Suzanne K. Powell

Download or read book Advanced Case Management written by Suzanne K. Powell and published by Lippincott Williams & Wilkins. This book was released on 2000 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advanced Case Management: Outcomes and Beyond, is a theoretical, research-oriented, and statistical publication providing comprehensive coverage of advanced case management information. Essential topics presented in this text include outcomes management, disease management, continuous quality improvement (CQI), and complementary medicine practices. Building on Case Management: A Practical Guide to Success in Managed Care, Second Edition, this book explores population-based case management and its components. Part I comprehensively covers disease management concepts and development of a successful disease management program. Part II focuses on the latest trends in outcomes management. Topics covered include how to develop an outcomes management program, the Center for Case Management Accountability (CCMA), benchmarking, and factors affecting case management outcomes. Part III deals with continuous quality improvement (CQI) and proper use of CQI tools. Finally, Part IV, Managing Complementary Health Care--A Vision for the Future, addresses the challenges and the successes of Complementary and Alternative Medicine (CAM) practices.