Advertisement
| case management models in hospitals: 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. |
| case management models in hospitals: The Leader's Guide to Hospital Case Management Stefani Daniels, Marianne Ramey, 2005 This text will address the role of the hospital case manager from a busniess perspective rather than a nursing perspective. Will engage all areas that are involved with the health care system, in pursuit of global objectives on behalf of every stakeholder. |
| case management models in hospitals: Hospital Case Management Models Karen S. Zander, 2008 The right case management model can make or break your efforts to meet your organization's strategic goals. But how do you find the model that works for your organization and how can you garner the support you need from your organization's executive team? In this first-of-its-kind resource, case management expert Karen Zander, RN, MS, CMAC, FAAN, guides you through selecting and implementing a proven model that fits cohesively with your facility's culture in Hospital Case Management Models: Evidence for Connecting the Boardroom to the Bedside. Align case management with your organization's top strategic goals This new book will help you choose a model that aligns with your board's mission. You'll learn how to carry your model through your organization and operationalize it at the bedside through direct patient interaction by case managers and social workers. Plus, you'll get the guidance you need to gain support from your executive team. |
| case management models in hospitals: 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. |
| case management models in hospitals: 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. |
| case management models in hospitals: CCM Certification Made Easy Andrea Morris, 2016-07-20 We are extremely pleased to tell you that CCM Certification Made Easy has been updated to it's Second Edition, and includes all the new material recently added to the CCM Exam. Every subdomain is covered on the exam. CCM Certification Made Easy is clearly the most complete CCM Exam prep book you can buy.Up to date - every area has been revisited for this updated edition to keep pace with the substantial changes in healthcare and the CCM Exam.Includes a condensed versions of the CCMC's Glossary of Terms that are an essential resource to pass the CCM Exam.Includes a website link to download a free companion workbook and study strategies that countless case managers have used to pass the CCM Exam at no extra charge. |
| case management models in hospitals: Core Skills for Hospital Case Managers Tony Cesta, Beverly Cunningham, 2009-06 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 |
| case management models in hospitals: Conditions of Participation for Hospitals United States. Social Security Administration, 1966 |
| case management models in hospitals: Patient Safety and Quality Ronda Hughes, 2008 Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043). - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/ |
| case management models in hospitals: Case Management Suzanne K. Powell, Hussein M. Tahan, 2018-02-26 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 models in hospitals: Hospitals & Health Care Organizations David Edward Marcinko, Hope Rachel Hetico, 2012-07-06 Drawing on the expertise of decision-making professionals, leaders, and managers in health care organizations, Hospitals & Health Care Organizations: Management Strategies, Operational Techniques, Tools, Templates, and Case Studies addresses decreasing revenues, increasing costs, and growing consumer expectations in today’s increasingly competitive health care market. Offering practical experience and applied operating vision, the authors integrate Lean managerial applications, and regulatory perspectives with real-world case studies, models, reports, charts, tables, diagrams, and sample contracts. The result is an integration of post PP-ACA market competition insight with Lean management and operational strategies vital to all health care administrators, comptrollers, and physician executives. The text is divided into three sections: Managerial Fundamentals Policy and Procedures Strategies and Execution Using an engaging style, the book is filled with authoritative guidance, practical health care–centered discussions, templates, checklists, and clinical examples to provide you with the tools to build a clinically efficient system. Its wide-ranging coverage includes hard-to-find topics such as hospital inventory management, capital formation, and revenue cycle enhancement. Health care leadership, governance, and compliance practices like OSHA, HIPAA, Sarbanes–Oxley, and emerging ACO model policies are included. Health 2.0 information technologies, EMRs, CPOEs, and social media collaboration are also covered, as are 5S, Six Sigma, and other logistical enhancing flow-through principles. The result is a must-have, how-to book for all industry participants. |
| case management models in hospitals: 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. |
| case management models in hospitals: Case Management Shilpa Ross, Natasha Curry, Nick Goodwin, King's Fund (London, England), 2011 |
| case management models in hospitals: Nursing Staff in Hospitals and Nursing Homes Institute of Medicine, Committee on the Adequacy of Nursing Staff in Hospitals and Nursing Homes, 1996-03-27 Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system. |
| case management models in hospitals: 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. |
| case management models in hospitals: Medical Management of Vulnerable & Underserved Patients: Principles, Practice, Population Talmadge E. King, Margaret B. Wheeler, Alicia Fernandez, Dean Schillinger, Andrew B. Bindman, Kevin Grumbach, Teresa J. Villela, 2006-08-31 No other book on the subject Chronic diseases, especially those associated with poor nutrition, obesity, and addiction have grown to epidemic proportion in many poor and minority populations Covers all essential topics, including Navigating Language Barriers, Understanding Disability, Patient Education, Substance Abusers, the Care of Gay and Lesbian Patients, Reproductive Issues in Poor Women, and much more |
| case management models in hospitals: 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. |
| case management models in hospitals: The Future of Nursing Institute of Medicine, Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011-02-08 The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing. |
| case management models in hospitals: 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 |
| case management models in hospitals: CMSA Core Curriculum for Case Management Hussein M. Tahan, Teresa M. Treiger, 2016-07-05 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 |
| case management models in hospitals: 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). |
| case management models in hospitals: Financial Management Strategies for Hospitals and Healthcare Organizations David Edward Marcinko, Hope Rachel Hertico, 2013-09-05 In this book, a world-class editorial advisory board and an independent team of contributors draw on their experience in operations, leadership, and Lean managerial decision making to share helpful insights on the valuation of hospitals in today‘s changing reimbursement and regulatory environments.Using language that is easy to understand, Financia |
| case management models in hospitals: Emergency Department Case Management Karen S. Zander, 2007 Eliminate sky-high wait times and increased denials in your ED Hospitals across the country are seeing extreme backup in the emergency department (ED). In recent years, well-structured emergency department case management programs have repeatedly demonstrated their value in: Influencing capacity Assigning patients to appropriate levels of care Targeting complex discharge needs Assisting with proper utilization review Whether you are looking to implement, maintain, or evolve your ED case management program, eliminate confusion surrounding the process with the help of Emergency Department Case Management: Strategies for Creating and Sustaining a Successful Program. Examining all perspectives of ED case management, this new and comprehensive guide will help you define a program that best suits your facility's needs. All the tools you need to get your program up and running From defining goals, clarifying roles, and understanding the necessary knowledge and skill sets required from ED case management staff, Emergency Department Case Management will help to ensure that you have a solid and sustainable foundation in place. After exploring models and reviewing your infrastructure, Emergency Department Case Management will help you outline key partnerships, present multiple options for case finding, tackle observation status, address quality and evaluation issues, and identify ways ED case managers can contribute to care coordination for complex pediatric, psychiatric, homeless, and uninsured populations. Written by Kathleen Walsh, RN, MS, and Karen Zander RN, MS, CMAC, FAAN, from the Center for Case Management, Emergency Department Case Management provides advice and best practices from two of the nations top case management experts. Take a look inside at the table of contents: Chapter 1: ED Case Management: The Heart of Access Chapter 2: The Foundation Chapter 3: Partnerships Chapter 4: The Process Chapter 5: Developing interventional strategies Chapter 6: Observation status determination Chapter 7: Program-level evaluation Chapter 8: Information system support Chapter 9: Quality Chapter 10: Addressing the pediatric population Chapter 11: Responding to the psychiatric population Chapter 12: Strengthening an existing program It's also packed with 15 detailed case studies discussing ED case management strategies, as well as five spotlight accounts detailing the experiences of ED professionals from across the country, including: A case manager A social worker A psychiatric nurse An information systems specialist An ED physician Don't hesitate to jumpstart your ED case management program. From beginning to end, Emergency Department Case Management will serve as the lead architect to help you design, build, and strengthen your ED case management model--order your copy today! Learning objectives: Conceptualize a framework for setting up an ED case management program Develop policies, procedures, and role descriptions Identify structural components, tools, and processes to support an ED case management program Describe potential outcomes of an ED case management program Who should buy this book? Emergency Department Case Management is the perfect resource for case managers, directors of case management, ED nurse managers, social workers, ED directors/administrators, and CFOs. HCPro Inc. has confirmed that none of the faculty presenters or contributors has any relevant financial relationships to disclose related to the content of this educational activity.The HCPro Risk-Free, Money-Back Guarantee If for any reason you're not completely satisfied with your purchase, return it within 30 days and you will receive a prompt, polite, 100% refund--no questions asked. |
| case management models in hospitals: The Future of the Public's Health in the 21st Century Institute of Medicine, Board on Health Promotion and Disease Prevention, Committee on Assuring the Health of the Public in the 21st Century, 2003-02-01 The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists. |
| case management models in hospitals: 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. |
| case management models in hospitals: The Hospital Guide to Contemporary Utilization Review Stefani Daniels, Ronald L Hirsch, MD, Facp, Chcqm, Ronald L. Hirsch, 2015-04-16 The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives |
| case management models in hospitals: Handbook of Healthcare Operations Management Brian T. Denton, 2013-02-28 From the Preface: Collectively, the chapters in this book address application domains including inpatient and outpatient services, public health networks, supply chain management, and resource constrained settings in developing countries. Many of the chapters provide specific examples or case studies illustrating the applications of operations research methods across the globe, including Africa, Australia, Belgium, Canada, the United Kingdom, and the United States. Chapters 1-4 review operations research methods that are most commonly applied to health care operations management including: queuing, simulation, and mathematical programming. Chapters 5-7 address challenges related to inpatient services in hospitals such as surgery, intensive care units, and hospital wards. Chapters 8-10 cover outpatient services, the fastest growing part of many health systems, and describe operations research models for primary and specialty care services, and how to plan for patient no-shows. Chapters 12 – 16 cover topics related to the broader integration of health services in the context of public health, including optimizing the location of emergency vehicles, planning for mass vaccination events, and the coordination among different parts of a health system. Chapters 17-18 address supply chain management within hospitals, with a focus on pharmaceutical supply management, and the challenges of managing inventory for nursing units. Finally, Chapters 19-20 provide examples of important and emerging research in the realm of humanitarian logistics. |
| case management models in hospitals: 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. |
| case management models in hospitals: Optimizing the Physician Advisor in Case Management Mark S. Michelman, Sharon Mass, Donna Ukanowicz, 2008-11 Foster effective relationships between case management and physicians with a strong physician advisor program. With increasing federal compliance regulations, there has never been a greater need to have a physician advisor (PA) on staff to provide your case management team with more support to achieve your organizational goals. Whether you're building a new PA program or want to revitalize an existing one, the new HCPro book Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results delivers the guidance you need to improve the chain of communication across the continuum of care. Written by Mark Michelman, MD, MBA, Sharon Mass, PhD, LCSW, ACM, and Donna Ukanowicz, MS, RN, ACM, the book combines the perspectives of a physician advisor, nursing case manager, and social work case manager. The book is the industry's first resource that provides: Easy-to-follow steps to create or revamp your program Tips to recruit and train PAs Strategies for defining measurable goals and effective PA responsibilities Analysis methods for evaluating need and justifying resources Metrics to measure your success A CD-ROM loaded with adaptable tools and forms |
| case management models in hospitals: Living Well with Chronic Illness Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Living Well with Chronic Disease: Public Health Action to Reduce Disability and Improve Functioning and Quality of Life, 2011-06-30 In the United States, chronic diseases currently account for 70 percent of all deaths, and close to 48 million Americans report a disability related to a chronic condition. Today, about one in four Americans have multiple diseases and the prevalence and burden of chronic disease in the elderly and racial/ethnic minorities are notably disproportionate. Chronic disease has now emerged as a major public health problem and it threatens not only population health, but our social and economic welfare. Living Well with Chronic Disease identifies the population-based public health actions that can help reduce disability and improve functioning and quality of life among individuals who are at risk of developing a chronic disease and those with one or more diseases. The book recommends that all major federally funded programmatic and research initiatives in health include an evaluation on health-related quality of life and functional status. Also, the book recommends increasing support for implementation research on how to disseminate effective longterm lifestyle interventions in community-based settings that improve living well with chronic disease. Living Well with Chronic Disease uses three frameworks and considers diseases such as heart disease and stroke, diabetes, depression, and respiratory problems. The book's recommendations will inform policy makers concerned with health reform in public- and private-sectors and also managers of communitybased and public-health intervention programs, private and public research funders, and patients living with one or more chronic conditions. |
| case management models in hospitals: Service Quality for Facilities Management in Hospitals Low Sui Pheng, Zhu Rui, 2016-05-12 This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hospitals. Although the book was written from the perspective of FM service quality for hospitals, the findings and recommendations are also relevant for other non-healthcare sectors where appropriate lessons may also be drawn for FM and service quality in general. It will particularly benefit Quality Managers, Facilities Managers and Hospital Administrators. |
| case management models in hospitals: Case Management Mary Hubbard Linz, Patricia L. McAnally, Colleen Ann Wieck, 1989 |
| case management models in hospitals: Chronic Illness Ilene Morof Lubkin, 2006 The best-selling Chronic Illness: Impact and Intervention continues to focus on the various aspects of chronic illness that influence both patients and their families. Topics include the sociological, psychological, ethical, organizational, and financial factors, as well as individual and system outcomes. the revised Sixth Edition includes new chapters on palliative care, complementary and alternative therapies, and self-efficacy, as well as added material on culturally competent care. Intended for nurses, social workers, and rehabilitation professionals, Chronic Illness demonstrates how the h |
| case management models in hospitals: Operations Research and Health Care Margaret L. Brandeau, Francois Sainfort, William P. Pierskalla, 2006-04-04 In both rich and poor nations, public resources for health care are inadequate to meet demand. Policy makers and health care providers must determine how to provide the most effective health care to citizens using the limited resources that are available. This chapter describes current and future challenges in the delivery of health care, and outlines the role that operations research (OR) models can play in helping to solve those problems. The chapter concludes with an overview of this book – its intended audience, the areas covered, and a description of the subsequent chapters. KEY WORDS Health care delivery, Health care planning HEALTH CARE DELIVERY: PROBLEMS AND CHALLENGES 3 1.1 WORLDWIDE HEALTH: THE PAST 50 YEARS Human health has improved significantly in the last 50 years. In 1950, global life expectancy was 46 years [1]. That figure rose to 61 years by 1980 and to 67 years by 1998 [2]. Much of these gains occurred in low- and middle-income countries, and were due in large part to improved nutrition and sanitation, medical innovations, and improvements in public health infrastructure. |
| case management models in hospitals: Financial Management for Nurse Managers Janne Dunham-Taylor, Joseph Pinczuk, 2009-11-24 Completely revised and updated, the Second Edition addresses a myriad of financial concepts ranging from staffing and budgeting to measuring productivity and forecasting costs. Examples and explanations of terminology will help nurse managers successfully correspond with the financial department to implement change without negatively affecting patient care and outcomes. |
| case management models in hospitals: Leadership and Nursing Care Management - E-Book Diane Huber, 2017-07-26 - Updated! Chapter on the Prevention of Workplace Violence emphasizes the AONE, Joint Commission's, and OSHA's leadership regarding ethical issues with disruptive behaviors of incivility, bullying, and other workplace violence. - Updated! Chapter on Workplace Diversity includes the latest information on how hospitals and other healthcare facilities address and enhance awareness of diversity. - Updated! Chapter on Data Management and Clinical Informatics covers how new technology helps patients be informed, connected, and activated through social networks; and how care providers access information through mobile devices, data dashboards, and virtual learning systems. |
| case management models in hospitals: Health Care Management Montague Brown, 1992 This volume offers the insights of management experts on options such as diversification, mergers and acquisitions, vertical integration, wh at total quality management is all about, and how it fits into the org anizational structure. Health care managers will find proven methods f or planning for future growth and fostering good relationships with cu stomers, government agencies, and suppliers. |
| case management models in hospitals: 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. |
| case management models in hospitals: 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. |
| case management models in hospitals: Management and Leadership for Nurse Managers Russell C. Swansburg, 1996 This edition of the highly acclaimed Management and Leadership for Nurse Managers offers theoretical and practical perspectives on the major management functions as they are practiced in today's organizations. The author introduces current and future nurse managers to the challenges of planning, organizing, leading, and controlling. The most recent research on management theory is incorporated throughout the book in the context of its practical application. New coverage includes total quality management, pay-for-performance, the rising temporary workforce, and downsizing. |
CASE Equipment | CASE - CASE Construction Equipment
Powerful and stable machines capable of moving the earth without tearing up the turf below. CASE compact track loaders are simple, intuitive and productive — and we've got a solution …
No one will push harder than CASE Construction Equipment
Seven Brand-new CASE machines including two new midi excavators, two new compact wheel loaders, two new motor graders and a telescopic small articulated loader.
421G Compact Wheel Loader - CASE Construction Equipment
CASE dealers provide world-class equipment and aftermarket support, industry-leading warranties and flexible financing.
CASE Construction Equipment
CASE sells and supports a full line of construction equipment around the world, including backhoe loaders, excavators, wheel loaders, dozers, skid steer loaders, compaction equipment, …
Maquinaria de Construcción | CASE ES - CASE Construction …
Confía en los líderes en maquinaria de construcción. CASE te ofrece soluciones innovadoras, calidad insuperable y rendimiento excepcional.
CASE Maquinaria de Construcción en México | Tractores, …
CASE México ofrece una amplia gama de maquinaria pesada para la construcción: tractores, excavadoras, retroexcavadoras, compactadoras y más. Descubre soluciones eficientes y …
Construction Machinery & Equipment | CASE CIS - CASE …
Explore high-performance CASE construction equipment, designed for power, precision, and efficiency across every job site.
CASE SL27 TR Small Articulated Loader | CASE - CASE Construction …
CASE dealers provide world-class equipment and aftermarket support, industry-leading warranties and flexible financing.
695SV Construction King™ Center Pivot Backhoe Loader - CASE
It’s the new CASE 695SV Construction King™ Center Pivot Backhoe Loader. And it’s 21,540 lb. of pure digging, loading, pushing, trenching and drilling might. The first thing to jump out at you …
Equipamentos de Construção e Máquinas Pesadas - Case …
Descubra a linha completa de equipamentos de construção da Case, incluindo retroescavadeiras, escavadeiras e mais. Explore soluções inovadoras para todos os seus projetos de construção.
CASE Equipment | CASE - CASE Construction Equipment
Powerful and stable machines capable of moving the earth without tearing up the turf below. CASE compact track loaders are simple, intuitive and productive — and we've got a solution …
No one will push harder than CASE Construction Equipment
Seven Brand-new CASE machines including two new midi excavators, two new compact wheel loaders, two new motor graders and a telescopic small articulated loader.
421G Compact Wheel Loader - CASE Construction Equipment
CASE dealers provide world-class equipment and aftermarket support, industry-leading warranties and flexible financing.
CASE Construction Equipment
CASE sells and supports a full line of construction equipment around the world, including backhoe loaders, excavators, wheel loaders, dozers, skid steer loaders, compaction equipment, …
Maquinaria de Construcción | CASE ES - CASE Construction …
Confía en los líderes en maquinaria de construcción. CASE te ofrece soluciones innovadoras, calidad insuperable y rendimiento excepcional.
CASE Maquinaria de Construcción en México | Tractores, …
CASE México ofrece una amplia gama de maquinaria pesada para la construcción: tractores, excavadoras, retroexcavadoras, compactadoras y más. Descubre soluciones eficientes y …
Construction Machinery & Equipment | CASE CIS - CASE …
Explore high-performance CASE construction equipment, designed for power, precision, and efficiency across every job site.
CASE SL27 TR Small Articulated Loader | CASE - CASE …
CASE dealers provide world-class equipment and aftermarket support, industry-leading warranties and flexible financing.
695SV Construction King™ Center Pivot Backhoe Loader - CASE
It’s the new CASE 695SV Construction King™ Center Pivot Backhoe Loader. And it’s 21,540 lb. of pure digging, loading, pushing, trenching and drilling might. The first thing to jump out at you is …
Equipamentos de Construção e Máquinas Pesadas - Case …
Descubra a linha completa de equipamentos de construção da Case, incluindo retroescavadeiras, escavadeiras e mais. Explore soluções inovadoras para todos os seus projetos de construção.
