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CMSA's Integrated Case Management

CMSA's Integrated Case Management
Author: Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN
Publisher: Springer Publishing Company
Total Pages: 316
Release: 2018-01-28
Genre: Medical
ISBN: 0826169511

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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.


Advances in Patient Safety

Advances in Patient Safety
Author: Kerm Henriksen
Publisher:
Total Pages: 526
Release: 2005
Genre: Medical
ISBN:

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v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.


Social Work Case Management

Social Work Case Management
Author: Michael J. Holosko
Publisher: SAGE Publications
Total Pages: 520
Release: 2017-01-30
Genre: Social Science
ISBN: 1483374491

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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.


Case Management Models, Second Edition

Case Management Models, Second Edition
Author: Karen Zander
Publisher: Hcpro, a Division of Simplify Compliance
Total Pages: 0
Release: 2017-06-28
Genre: Accountable care organizations (Medical care)
ISBN: 9781683085614

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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.


The Hospital Case Management Orientation Manual

The Hospital Case Management Orientation Manual
Author: Peggy Rossi, Bsn, Mpa, CCM
Publisher: Hcpro, a Division of Simplify Compliance
Total Pages: 0
Release: 2014-06-12
Genre: Health services administration
ISBN: 9781615692910

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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.


Social Work Case Management

Social Work Case Management
Author: Betsy Vourlekis
Publisher: Routledge
Total Pages: 295
Release: 2017-07-05
Genre: Social Science
ISBN: 135148933X

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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.


Nursing Case Management

Nursing Case Management
Author: Elaine Cohen
Publisher: Elsevier Health Sciences
Total Pages: 650
Release: 2004-08-26
Genre: Medical
ISBN: 9780323027656

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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


Emergency Department Case Management, Second Edition

Emergency Department Case Management, Second Edition
Author: Kathleen Walsh
Publisher:
Total Pages: 0
Release: 2014-11-14
Genre:
ISBN: 9781615693801

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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.


Crossing the Quality Chasm

Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 360
Release: 2001-08-19
Genre: Medical
ISBN: 0309072808

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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.