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| care coordination vs case management: Closing the Quality Gap Kaveh G. Shojania, 2004 |
| care coordination vs case management: CMSA's Integrated Case Management Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN, Rebecca Perez, MSN, RN, CCM, FCM, Corine Latour, PhD, RN, 2018-01-28 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. |
| care coordination vs case management: Promoting the Health of the Community Julie Ann St. John, Susan L. Mayfield-Johnson, Wandy D. Hernández-Gordon, 2021-03-22 Community health workers (CHWs) are an increasingly important member of the healthcare and public health professions who help build primary care capacity. Yet, in spite of the exponential growth of CHW interventions, CHW training programs, and CHW certification and credentialing by state agencies, a gap persists in the literature regarding current CHW roles and skills, scope of practice, CHW job settings, and national standards. This collection of contributions addresses this gap by providing information, in a single volume, about CHWs, the roles CHWs play as change agents in their communities, integration of CHWs into healthcare teams, and support and recognition of the CHW profession. The book supports the CHW definition as defined by the American Public Health Association (APHA), Community Health Worker Section (2013), which states, “A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.” The scope of the text follows the framework of the nationally recognized roles of CHWs that came out of a national consensus-building project called “The Community Health Worker (CHW) Core Consensus (C3) Project”. Topics explored among the chapters include: Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems Care Coordination, Case Management, and System Navigation Advocating for Individuals and Communities Building Individual and Community Capacity Implementing Individual and Community Assessments Participating in Evaluation and Research Uniting the Workforce: Building Capacity for a National Association of Community Health Workers Promoting the Health of the Community is a must-have resource for CHWs, those interested in CHW scope of practice and/or certification/credentialing, anyone interested in becoming a CHW, policy-makers, CHW payer systems, CHW supervisors, CHW employers, CHW instructors/trainers, CHW advocates/supporters, and communities served by CHWs. |
| care coordination vs case management: Crossing the Quality Chasm Institute of Medicine, Committee on Quality of Health Care in America, 2001-07-19 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. |
| care coordination vs case management: Introduction to Care Coordination and Nursing Management Laura J. Fero, Charlotte Anne Herrick, Jie Hu (Ph. D.), 2011 A new and updated version of this best-selling resource! Jones and Bartlett Publisher's 2011 Nurse's Drug Handbook is the most up-to-date, practical, and easy-to-use nursing drug reference! It provides: Accurate, timely facts on hundreds of drugs from abacavir sulfate to Zyvox; Concise, consistently formatted drug entries organized alphabetically; No-nonsense writing style that speaks your language in terms you use everyday; Index of all generic, trade, and alternate drug names for quick reference. It has all the vital information you need at your fingertips: Chemical and therapeutic classes, FDA pregnancy risk category and controlled substance schedule; Indications and dosages, as well as route, onset, peak, and duration information; Incompatibilities, contraindications; interactions with drugs, food, and activities, and adverse reactions; Nursing considerations, including key patient-teaching points; Vital features include mechanism-of-action illustrations showing how drugs at the cellular, tissue, or organ levels and dosage adjustments help individualize care for elderly patients, patients with renal impairment, and others with special needs; Warnings and precautions that keep you informed and alert. |
| care coordination vs case management: Social Work Case Management Betsy Vourlekis, 2017-07-05 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. |
| care coordination vs case management: Medical Quality Management Angelo P. Giardino, Lee Ann Riesenberg, Prathibha Varkey, 2020-08-31 This comprehensive medical textbook is a compendium of the latest information on healthcare quality. The text provides knowledge about the theory and practical applications for each of the core areas that comprise the field of medical quality management as well as insight and essential briefings on the impact of new healthcare technologies and innovations on medical quality and improvement. The third edition provides significant new content related to medical quality management and quality improvement, a user-friendly format, case studies, and updated learning objectives. This textbook also serves as source material for the American Board of Medical Quality in the development of its core curriculum and certification examinations. Each chapter is designed for a review of the essential background, precepts, and exemplary practices within the topical area: Basics of Quality Improvement Data Analytics for the Improvement of Healthcare Quality Utilization Management, Case Management, and Care Coordination Economics and Finance in Medical Quality Management External Quality Improvement — Accreditation, Certification, and Education The Interface Between Quality Improvement and Law Ethics and Quality Improvement With the new edition of Medical Quality Management: Theory and Practice, the American College of Medical Quality presents the experience and expertise of its contributors to provide the background necessary for healthcare professionals to assume the responsibilities of medical quality management in healthcare institutions, provide physicians in all medical specialties with a core body of knowledge related to medical quality management, and serve as a necessary guide for healthcare administrators and executives, academics, directors, medical and nursing students and residents, and physicians and other health practitioners. |
| care coordination vs case management: Health and Human Services Issues United States. General Accounting Office, 1993 Discussing major policy, management, and program issues facing Congress and the Clinton administration in the area of health and human services, this pamphlet provides recommendations for the Department of Health and Human Services (HHS) regarding the social security system, the welfare system, preventing child abuse, and safeguarding the nation's food supply. Following an overview of important issues facing the nation, the second section suggests steps to bolster public confidence in the social security system, including building the system's trust fund by increasing contribution levels and modernizing computer systems. The next section provides recommendations for continuing the welfare reform movement and the implementation of the Family Support Act, such as developing automated data systems to effectively manage caseloads, setting goal-oriented program performance standards, and identifying and sharing effective initiatives between states. The fourth section suggests that HHS provide states with greater flexibility in using government funds to prevent child abuse through early intervention and that a national foster care system be developed to provide outcome-oriented data on child welfare services. The final section proposes that an agency-wide system for tracking regulation development be implemented in the Food and Drug Administration to improve agency effectiveness and better allocate existing resources. Includes references for 22 related GAO products. (BCY). |
| care coordination vs case management: The 1st Annual Crossing the Quality Chasm Summit Institute of Medicine, Board on Health Care Services, Committee on the Crossing the Quality Chasm: Next Steps Toward a New Health Care System, 2004-09-13 In January 2004, the Institute of Medicine (IOM) hosted the 1st Annual Crossing the Quality Chasm Summit, convening a group of national and community health care leaders to pool their knowledge and resources with regard to strategies for improving patient care for five common chronic illnesses. This summit was a direct outgrowth and continuation of the recommendations put forth in the 2001 IOM report Crossing the Quality Chasm: A New Health System for the 21st Century. The summit's purpose was to offer specific guidance at both the community and national levels for overcoming the challenges to the provision of high-quality care articulated in the Quality Chasm report and for moving closer to achievement of the patient-centerd health care system envisioned therein. |
| care coordination vs case management: The Hospital Case Management Orientation Manual Peggy Rossi, Bsn, Mpa, CCM, Karen Zander, 2014-06-12 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. |
| care coordination vs case management: Case Management Arthur J. Frankel, Sheldon Gelman, Diane K. Pastor, 2019 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. |
| care coordination vs case management: The Case Manager's Handbook Catherine M. Mullahy, 2013-06-20 Written by renowned author Catherine Mullahy, The Case Manager’s Handbook, Fifth Edition is the ultimate how-to guide for case managers. This practical resource helps case managers build fundamentals, study for the Certified Case Manager (CCM) exam, and most importantly, advance their careers after the exam. Written for all professionals in all practice settings in case management, it uses real-life examples and an easy-to-read, conversational style to examine the case management process while presenting practical procedural information. An excellent daily reference and training guide for new case managers and seasoned professionals in various setting, The Case Manager’s Handbook, Fifth Edition is the “go-to” resource for facing the day-to-day challenges of case management, especially as the nation navigates through the many changes introduced by the landmark Patient Protection and Affordable Care Act. Significantly updated and revised, it contains eight new chapters: * Hospital Case Management: Changing Roles and Transitions of Care * Patient Centered Medical Home, ACOs, Health Exchanges * Evidence-Based Practice * Public Sector Reimbursement * Predictive Modeling * Pain Management * Health Technology, Trends, and Implications for Case Managers * The Affordable Care Act of 2010: Implications for Case Managers Included with each new print book is an Access Code for a Navigate Companion Website for students with objectives, multiple choice questions, and bonus appendices. |
| care coordination vs case management: Foundations of Case Management Deanna Cooper Gillingham, 2021-10-16 |
| care coordination vs case management: Case Management Models, Second Edition Karen Zander, 2017-06-28 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. |
| care coordination vs case management: Improving the Quality of Health Care for Mental and Substance-Use Conditions Institute of Medicine, Board on Health Care Services, Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders, 2006-03-29 Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€use conditions will benefit from this guide to achieving better care. |
| care coordination vs case management: Care Coordination in the NICU Sara L. Mosher, RN, MSN, MHA, 2018-08-28 Focuses on nurturing the emotional health of patients and families to ensure improved outcomes This innovative clinical practice resource for neonatal nurses embodies family-centered care strategies for optimal outcomes through every phase of the NICU experience. While rigorous programs provide the knowledge and skills to care for the physical needs of high-risk mothers and neonates, NICU practitioners often find themselves unprepared to support the emotional health of these patients and their families. Care Coordination in the NICU provides the education, inspiration, and resources to NICU health professionals so they can learn how to be emotionally supportive to their patient’s entire family unit. The book addresses a variety of challenging patient and family issues that occur in the NICU as they relate to care coordination throughout the process. Each chapter focuses on a particular area of the perinatal/neonatal family journey, and includes current medical research, clinical examples, and recommendations for best practice alongside case studies that depict families experiencing a perinatal challenge. Most valuable of all, each chapter also includes stories directly from the source, the families, who have experienced the fear, isolation, and uncertainly of an NICU experience, and have greatly benefited from the emotional support of caring practitioners. Key Features: Examines the gamut of challenging patient and family issues that occur in the NICU as they relate to care coordination throughout the process Helps practitioners to incorporate family-centered care into their daily practices Discusses effective listening and communication strategies for families in crisis Includes examples of practice improvement strategies to improve clinical outcome and reduce the risk of re-hospitalization Provides a Case-Based Learning section depicting real-world scenarios for discussion and problem-solving Includes links to abundant resources and educational material Contains chapters on palliative care and bereavement and supporting patients with special challenges. |
| care coordination vs case management: Care Coordination Gerri Lamb, 2014 Care coordination has always been a primary duty of nursing. This book, edited by Gerri Lamb Ph.D., RN, FAAN and with text from 23 contributing writers, offers comprehensive insights, case studies and strategies to advance nursing's role in care coordination and healthcare transformation. |
| care coordination vs case management: Case Management Mary Hubbard Linz, Patricia L. McAnally, Colleen Ann Wieck, 1989 |
| care coordination vs case management: The Integrated Case Management Manual Roger G. Kathol, Rachel L. Andrew, Michelle Squire, Peter J. Dehnel, 2018-06-14 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. |
| care coordination vs case management: Care Coordination Gerri Lamb, Robin Purdy Newhouse, 2018 Care Coordination : A Blueprint for Action for RNs, [the sequel to the ANA's Care Coordination: the Game Changer] helps today’s nurses reclaim this critical practice domain. It explores key issues in care coordination and offers timely, strategic actions nurses can take right now to identify opportunities and overcome barriers. It also includes critical resources for nurse care coordinators.. It also includes critical resources for nurse care coordinators. This book will help you: Understand care coordination - past, present, and future - as well as the professional and practice environments in which it occurs; define the activities associated with effective care coordination; recognize the significant need for care coordination and opportunities for nurses Identify and explore issues pivotal to creating new inroads for nursing to adapt and advance this important work; expand the capacity of nurses to deliver care coordination and develop new and better care coordination models. Learn how you and your fellow nurses can advance your important role in care coordination in the current and emerging health care environment. -- Publisher's website. |
| care coordination vs case management: Case Management Adherence Guide 2020 Case Management Society of America, 2021-07-30 Recognizing that the health care field has undergone significant changes in recent years, Case Management Adherence Guide 2020 helps health care professionals gain and integrate skills and methods for even more comprehensive assessments of clients, families, or their support systems. The guide supports improvements in care planning, care coordination, and care transitions. The guide is designed to help case management professionals achieve measureable outcomes with their interventions, rendering them more efficient, effective, and valuable to their employers, clients, and treatment teams. It provides readers with evidence-based assessment and intervention tools to improve patient treatment adherence. The tools found throughout the guide are in accordance with the standards set by the Case Management Society of America. Dedicated chapters cover the challenges in today's health care system, the important role that case managers play in improving outcomes, care coordination, and strategies for improving treatment and medication adherence. Seventeen appendices provide tools and references for PREPARE, shared decision-making, emotional intelligence, the Morisky Medication Adherence Scale, STEPSforward, care transition, telehealth resources, and more. Case Management Adherence Guide 2020 is an essential resource for future and practicing case management professionals. |
| care coordination vs case management: Health Professions Education Institute of Medicine, Board on Health Care Services, Committee on the Health Professions Education Summit, 2003-07-01 The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system. |
| care coordination vs case management: The Integrated Case Management Manual Roger G. Kathol, MD, Janice S. Cohen, PhD , CPsych, 2010-06-03 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 |
| care coordination vs case management: A Practical Guide to Acute Care Case Management Colleen M. Morley DNP CCM CMAC CMCN ACM-, 2021-12-15 |
| care coordination vs case management: Essentials of Managed Health Care Peter Reid Kongstvedt, 2003 |
| care coordination vs case management: Case Management and Care Coordination Janet Treadwell, Rebecca Perez, Debbie Stubbs, Jeanne W. McAllister, Susan Stern, Ruth Buzi, 2014-07-29 New collaborative models of health care service delivery are contributing to quality and cost improvements, especially in treating children and families. At the same time, deficits in communication between systems sharing patients can not only lead to confusion and waste, but also to increased risk of harm. Case Management and Care Coordination offers an evidence-based framework, best practices, and clinical common sense to meet this ongoing challenge. Focusing on families of children with chronic health issues, it outlines the processes of case management and care coordination, clarifies the roles and responsibilities of team members, and models streamlined, patient-centered service delivery. This analysis cuts through much of the complexity of case management while emphasizing collaboration, flexibility, and advocacy in pursuing best outcomes for patients. And as an extra dimension of usefulness, the book is accessible to lay readers, empowering families to make informed decisions and have a more active role in their own care. Included in the coverage: Essential skills for integrated case management. Children and youth with special health care needs. Transitional care and case management settings for children and families. Case management and home visitation programs. Managed care and care coordination. Technology and care coordination. Effectively illustrating the possibilities and potential of health care reform, Case Management and Care Coordination is an essential resource for pediatricians and health care professionals, as well as for families of children with special health care needs. |
| care coordination vs case management: Ask a Manager Alison Green, 2018-05-01 From the creator of the popular website Ask a Manager and New York’s work-advice columnist comes a witty, practical guide to 200 difficult professional conversations—featuring all-new advice! There’s a reason Alison Green has been called “the Dear Abby of the work world.” Ten years as a workplace-advice columnist have taught her that people avoid awkward conversations in the office because they simply don’t know what to say. Thankfully, Green does—and in this incredibly helpful book, she tackles the tough discussions you may need to have during your career. You’ll learn what to say when • coworkers push their work on you—then take credit for it • you accidentally trash-talk someone in an email then hit “reply all” • you’re being micromanaged—or not being managed at all • you catch a colleague in a lie • your boss seems unhappy with your work • your cubemate’s loud speakerphone is making you homicidal • you got drunk at the holiday party Praise for Ask a Manager “A must-read for anyone who works . . . [Alison Green’s] advice boils down to the idea that you should be professional (even when others are not) and that communicating in a straightforward manner with candor and kindness will get you far, no matter where you work.”—Booklist (starred review) “The author’s friendly, warm, no-nonsense writing is a pleasure to read, and her advice can be widely applied to relationships in all areas of readers’ lives. Ideal for anyone new to the job market or new to management, or anyone hoping to improve their work experience.”—Library Journal (starred review) “I am a huge fan of Alison Green’s Ask a Manager column. This book is even better. It teaches us how to deal with many of the most vexing big and little problems in our workplaces—and to do so with grace, confidence, and a sense of humor.”—Robert Sutton, Stanford professor and author of The No Asshole Rule and The Asshole Survival Guide “Ask a Manager is the ultimate playbook for navigating the traditional workforce in a diplomatic but firm way.”—Erin Lowry, author of Broke Millennial: Stop Scraping By and Get Your Financial Life Together |
| care coordination vs case management: CMSA Core Curriculum for Case Management , 2008 This text contains the core body of knowledge for case management practice as delineated by the Case Management Society of America (CMSA), the largest professional organization of case managers. The core curriculum provides a synthesis of case management evolution, and presents essential elements, concepts, and vision for current and future case management practice. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references. |
| care coordination vs case management: The Case Manager's Training Manual David W. Plocher, Patricia L. Metzger, 2001 Stem Cell and Bone Marrow Transplantation |
| care coordination vs case management: Code of Ethics for Nurses with Interpretive Statements American Nurses Association, 2001 Pamphlet is a succinct statement of the ethical obligations and duties of individuals who enter the nursing profession, the profession's nonnegotiable ethical standard, and an expression of nursing's own understanding of its commitment to society. Provides a framework for nurses to use in ethical analysis and decision-making. |
| care coordination vs case management: A Guide for Nurse Case Managers Charlotte Cox, 2010-08-12 The position of nurse case managers can be a rewarding but challenging career, as these managers play a vital role in a patient’s care. In A Guide for Nurse Case Managers, author Charlotte Cox provides an insightful guide to this evolving field of medicine. Geared for those working in hospital settings, clinics, and health plan offices, this helpful reference text provides guidelines, tips, and tools for becoming a successful nurse case manager. With more than thirty years of health care experience, Cox provides a detailed overview of this important nursing position that works to usher a patient through the health care system. A Guide for Nurse Case Managers • defines the case manager role; • provides an understanding of the basics of utilization and case management; • gives an overview of Medicare and Medicaid procedures; • discusses the care planning process; • shows how to structure a community resource base. Whether you are a new case manager, a student, or a seasoned nurse needing a refresher about job basics, A Guide for Nurse Case Managers will help to shape your practice, provide valuable tips and reference tools, and help you with proven organizational ideas to succeed in the career. |
| care coordination vs case management: Social Work Case Management Michael J. Holosko, 2017-01-30 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. |
| care coordination vs case management: Treatment Alternatives to Street Crime James A. Inciardi, Duane C. McBride, 1994-03 Treatment Alternatives to Street Crime (TASC) provides an objective bridge between two separate institutions: the criminal justice system and the drug treatment community. Under TASC, community-based supervision is made available to drug-involved individuals who would otherwise burden the justice system with their persistent drug-associated criminality. TASC operates in more than 100 jurisdictions. Covers: empirical and theoretical foundations of TASC; early years of TASC; early TASC evaluations; the current structure of TASC; and the future of TASC. References. |
| care coordination vs case management: Case Management Shilpa Ross, Natasha Curry, Nick Goodwin, King's Fund (London, England), 2011 |
| care coordination vs case management: Clinical Reasoning and Care Coordination in Advanced Practice Nursing RuthAnne Kuiper, PhD, RN, CNE, ANEF, Daniel J. Pesut, PhD, RN, PMHCNS-BC, FAAN, Tamatha E. Arms, DNP, PMHNP-BC, NP-C, 2016-04-28 Teaches students how to” think like an APRN” This book describes an innovative model for helping APRN students develop the clinical reasoning skills required to navigate complex patient care needs and coordination in advanced nursing practice. This model, the Outcome-Present-State-Test (OPT), encompasses a clear, step-by-step process that students can use to learn the skills of differential diagnosis and hone clinical reasoning strategies. This method facilitates understanding of the relationship among patient problems, outcomes, and interventions that focus on promoting patient safety and care coordination. It moves beyond traditional ways of problem solving by focusing on patient scenarios and stories and juxtaposing issues and outcomes that have been derived from an analysis of patient problems, evidence-based interventions, and desired outcomes. The model offers a blueprint for using standardized health care languages and provides strategies for developing reflective and complex thinking that becomes habitual. It embodies several levels of perspective related to patient-centered care planning, team-centered negotiation, and health care system considerations. Through patient stories and case scenarios, the text highlights care coordination strategies critical in complex patient situations. It provides students with the tools to collect patient information, determine priorities for care, and test interventions to reach health care outcomes by making clinical judgments during the problem-solving process. Concept maps illustrate complex patient care issues and how they relate to each other. For faculty use, the text provides links to relevant APN competencies and provides guidelines for using the OPT when supervising students in field settings. Key Features: Delivers a concrete learning model for developing creative thinking and problem solving in the clinical setting Offers a blueprint and structure for using standardized health care languages Includes patient stories and case scenarios to illustrate effective use of the OPT model Highlights care coordination strategies associated with complex client situations with the use of the Care Coordination Clinical Reasoning model Reinforces methods of reaching a diagnosis, outcomes, and interventions and how to duplicate the process |
| care coordination vs case management: Emergency Department Case Management, Second Edition Kathleen Walsh, Karen Zander, 2014-11-14 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. |
| care coordination vs case management: Advances in Patient Safety Kerm Henriksen, 2005 v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products. |
| care coordination vs case management: High Performance Healthcare: Using the Power of Relationships to Achieve Quality, Efficiency and Resilience Jody Hoffer Gittell, 2009-04-17 In her groundbreaking book The Southwest Airlines Way, Jody Hoffer Gittell revealed the management secrets of the company Fortune magazine called “the most successful airline in history.” Now, the bestselling business author explains how to apply those same principles in one of our nation’s largest, most important, and increasingly complex industries. High Performance Healthcare explains the critical concept of “relational coordination”—coordinating work through shared goals, shared knowledge, and mutual respect. Because of the way healthcare is organized, weak links exist throughout the chain of communication. Gittell clearly demonstrates that relational coordination strengthens those weak links, enabling providers to deliver high quality, efficient care to their patients. Using Gittell’s innovative management methods, you will improve quality, maximize efficiency, and compete more effectively. High Performance Healthcare walks you step by step through the process of: Identifying weak areas of relational coordination within your organization Transforming work practices that are creating barriers to relational coordination Building a high performance work system to foster consistent relational coordination across all disciplines The book includes case studies illustrating how some healthcare organizations are already transforming themselves using Gittell’s proven tools. It concludes by identifying industry-level obstacles to high performance healthcare and showing how individual organizations and their leaders can support sweeping change at the highest levels. Policy changes and increased access to care will not alone answer the healthcare industry’s problems. Timely, accurate, problem-solving communication that crosses all organizational boundaries is a powerful response to business as usual. High Performance Healthcare explains exactly how to achieve this crucial dynamic, providing a long-awaited cure to an industry in crisis. |
| care coordination vs case management: Comprehensive Case Management for Substance Abuse Treatment - TIP 27 U.S. Department of Health and Human Services, 2019-11-23 Case management has been variously classified as a skill group, a core function, service coordination, or a network of friendly neighbors. Although it defies precise definition, case management generally can be described as a coordinated approach to the delivery of health, substance abuse, mental health, and social services, linking clients with appropriate services to address specific needs and achieve stated goals. The Consensus Panel that developed this TIP believes that case management lends itself to the treatment of substance abuse, particularly for clients with other disorders and conditions who require multiple services over extended periods of time and who face difficulty in gaining access to those services. This document details the factors that programs should consider as they decide to implement case management or modify their current case management activities. This summary is excerpted from the main text, in which references to the research appear. |
| care coordination vs case management: Nursing Case Management Elaine Cohen, Toni G. Cesta, 2004-08-26 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 |
Care Coordination Payments Is there a difference between …
The aforementioned policy statement further compares care coordination to case management, which focuses only on a patients’ medical issues: Case managers work with and guide …
Comparison of Targeted Case Management and Care …
The role of Targeted Case Management and Care Coordination are complementary and should work as a unit to focus on opportunities for integrating care and services, improving …
Department of Veterans Affairs VHA DIRECTIVE 1110.04(1) …
Sep 11, 2019 · Care coordination is a system-wide approach to the deliberate organization of all Veteran care activities between two or more participants or systems to facilitate the appropriate …
Comparison of CCBHC Care Coordination Criteria to BHH, MH …
This chart compares the federal care coordination criteria for CCBHCs to care coordination requirements for Behavioral Health Home (BHH) services, Mental Health Targeted Case …
Certified Community Behavioral Health Clinics
Assess current case management and care coordination workflows. Build Partnerships: Establish formal care coordination agreements. Modify Workflows and Train Staff: Equip teams with …
Care Coordination for Certified Community Behavioral Health …
Case Management vs. Care Coordination •Case management is a service –Helping an individual gain access to needed supports and services –Rule 132 service/DASA contracts •Care …
Behavioral Health Care Coordination - UPMC Children's …
care coordination is and why it’s important • Recognize the aspects of behavioral health care coordination and how they improve patient experience and outcomes • Consider strategies to …
Continuity and coordination of care - World Health Organization
Care coordination: a proactive approach to bringing together care professionals and providers to meet the needs of service users to ensure that they receive integrated, person-focused care …
Coordination of Services and Care for Medicaid Members in
Apr 27, 2016 · What is Case Management? Case management is a reimbursable service that is defined by DMAS as: • A service to assist individuals, eligible under the State Plan who reside …
Care Coordination Versus Case Management - SRHD
In Washington state, five Medicaid Managed Care Organizations (MCOs) are contracted to deliver Integrated Managed Care (ICM) services to eligible Medicaid clients, including care …
Disease Management, Case Management, Care Management, …
Care management is distinguished from case management in that it can occur in any care setting (e.g., inpatient or outpatient) and for all care recipi-ents regardless of program or payment …
Health Homes in Supportive Housing Case Management vs.
Case Management vs. Care Coordination Presentation by The Center for Urban Community Services Presenters: Carolyn Baginski, Program Director Venus Alfaro, Care Coordinator
Care Coordination Vs Case Management (Download Only)
Effectively illustrating the possibilities and potential of health care reform Case Management and Care Coordination is an essential resource for pediatricians and health care professionals as …
Care Coordination Models and Tools: A Systematic Review …
effective care coordination interventions as those that reduced hospitalizations and/or ED visits. We sought information about the key characteristics of effective interventions, such as …
PPL 24-001 TCM and ECM Coordination Policy - DHCS
Enhanced Care Management (ECM) is a Medi-Cal managed care benefit under CalAIM that addresses clinical and non-clinical needs of the highest-need, high-cost enrollees through …
Complex Care Management Guidelines - Mi-CCSI
This document is a guide to help you prepare, refine, and train for the complex care management of individuals with multiple chronic conditions, limited functional status, and/or psychosocial …
Basics of Case Management - HFMA
Feb 5, 2023 · What is the difference of Case Management & Utilization Review? Case Management: Coordinates care and assists the patient to navigate the system to attain the …
MEDICAID TARGETED CASE MANAGEMENT FREQUENTLY …
What is the difference between Medicaid Targeted Case Management (MTCM) and service coordination? Response: South Carolina Department of Health and Human Services …
Case Management Vs Care Coordination (Download Only)
Vourlekis,Roberta R. Greene,2017-07-05 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 …
Case Management Vs Care Coordination - old.icapgen.org
approach towards systematically integrating physical and mental health case management principles and assessment tools Since the health care field has undergone major changes …
Care Coordination Payments Is there a differe…
The aforementioned policy statement further compares care coordination to case management, which focuses only on a patients’ medical issues: Case …
Comparison of Targeted Case Management and Ca…
The role of Targeted Case Management and Care Coordination are complementary and should work as a unit to focus on opportunities for …
Department of Veterans Affairs VHA DIRECTIVE 111…
Sep 11, 2019 · Care coordination is a system-wide approach to the deliberate organization of all Veteran care activities between two or more …
Comparison of CCBHC Care Coordination Criteria to B…
This chart compares the federal care coordination criteria for CCBHCs to care coordination requirements for Behavioral Health Home (BHH) …
Certified Community Behavioral Health Clinics
Assess current case management and care coordination workflows. Build Partnerships: Establish formal care coordination agreements. Modify …
