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Author: Annette Marie Totten
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
In 2010, the Agency for Healthcare Research and Quality (AHRQ) charged the Oregon Evidence-based Practice Center (EPC) with conducting a review to evaluate the comparative effectiveness of outpatient case management (CM) as an intervention strategy for chronic illness management. The aims of the review were to assess the evidence pertaining to the effectiveness of CM in improving patient-centered outcomes, quality of care, and resource utilization in adults with chronic medical illness and complex care needs. It also evaluated the effectiveness of CM based on patient and intervention characteristics. After synthesizing the results from 109 studies, the original Comparative Effectiveness Review (CER) concluded that, while there were a number of approaches to CM matching the review's definition and scope, the interventions had limited impact on patient-centered outcomes, quality of care, and resource utilization among patients with chronic medical illness. Nevertheless, the review was able to identify some clinical settings in which CM had positive (though modest) effects on these outcomes. The objective of this Future Research Needs (FRN) project was to engage a range of stakeholders and combine their insight with the results of the CER and a scan of the recent literature and studies in progress. Drawing from all these sources we sought to identify and prioritize topics for future research that could inform health care decisionmaking and policy regarding CM.
Author: Annette Marie Totten
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
In 2010, the Agency for Healthcare Research and Quality (AHRQ) charged the Oregon Evidence-based Practice Center (EPC) with conducting a review to evaluate the comparative effectiveness of outpatient case management (CM) as an intervention strategy for chronic illness management. The aims of the review were to assess the evidence pertaining to the effectiveness of CM in improving patient-centered outcomes, quality of care, and resource utilization in adults with chronic medical illness and complex care needs. It also evaluated the effectiveness of CM based on patient and intervention characteristics. After synthesizing the results from 109 studies, the original Comparative Effectiveness Review (CER) concluded that, while there were a number of approaches to CM matching the review's definition and scope, the interventions had limited impact on patient-centered outcomes, quality of care, and resource utilization among patients with chronic medical illness. Nevertheless, the review was able to identify some clinical settings in which CM had positive (though modest) effects on these outcomes. The objective of this Future Research Needs (FRN) project was to engage a range of stakeholders and combine their insight with the results of the CER and a scan of the recent literature and studies in progress. Drawing from all these sources we sought to identify and prioritize topics for future research that could inform health care decisionmaking and policy regarding CM.
Author: U. S. Department Human Services
Publisher: Createspace Independent Publishing Platform
ISBN: 9781484086117
Category :
Languages : en
Pages : 0
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Book Description
Chronic diseases are the leading cause of illness, disability, and death in the U.S. Providing medical care for chronic illness is often complex, as patients require multiple resources, treatments, and providers. One strategy for improving care for chronic conditions is to develop programs that improve care coordination and implement care plans. Case management (CM) is one such supplemental service, in which a person takes responsibility for coordinating and implementing a patient's care plan, either alone or in conjunction with a team of health professionals. CM tends to be more intensive in time and resources than other chronic illness management interventions, and it is important to evaluate its specific value. CM is often utilized when the coordination and integration of care is difficult for patients to accomplish on their own. CM usually involves high-intensity engagement with patients, and case managers often adopt a supervisory role in comprehensively attending to patients' complex needs. Conceptually, a case manager can be seen as an agent of the patient, taking a "whole-person" (rather than solely clinical or disease-focused) approach to care, and serving as a bridge between the patient, the practice team, the health system, and community resources. The coordinating functions performed by a case manager include helping patients navigate health care systems, connecting them with community resources, orchestrating multiple facets of health care delivery, and assisting with administrative and logistical tasks. Case managers also can perform clinical functions, including disease-oriented assessment and monitoring, medication adjustment, health education, and self-care instructions. Such clinical functions are often the defining aspects of other chronic illness management interventions. In the context of chronic illness care, they are central to the role of a case manager, but a case manager also performs coordinating functions. The Agency for Healthcare Research and Quality (AHRQ) commissioned this review to examine the evidence for the effectiveness of CM programs for chronic illness patients with complex care needs. Specifically, we considered interventions in which case managers had a substantive role in performing both clinical and coordinating functions. This report summarizes the existing evidence addressing the following Key Questions: KQ1: In adults with chronic medical illness and complex care needs, is case management effective in improving: a. Patient-centered outcomes, including mortality, quality of life, disease-specific health outcomes, avoidance of nursing home placement, and patient satisfaction with care? b. Quality of care, as indicated by disease-specific process measures, receipt of recommended health care services, adherence to therapy, missed appointments, patient self-management, and changes in health behavior? c. Resource utilization, including overall financial cost, hospitalization rates, days in the hospital, emergency department use, and number of clinic visits (including primary care and other provider visits)? KQ2: Does the effectiveness of case management differ according to patient characteristics, including but not limited to: particular medical conditions, number or type of comorbidities, patient age and socioeconomic status, social support, and/or level of formally assessed health risk? KQ3: Does the effectiveness of case management differ according to intervention characteristics, including but not limited to: practice or health care system setting; case manager experience, training, or skills; case management intensity, duration, and integration with other care providers; and the specific functions performed by case managers?
Author: Roger G. Kathol
Publisher: Springer
ISBN: 3319747428
Category : Medical
Languages : en
Pages : 335
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Book Description
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.
Author: Roger G. Kathol
Publisher: Humana Press
ISBN: 3319289594
Category : Medical
Languages : en
Pages : 343
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Book Description
Improving the outcomes for patients in our changing healthcare system is not straightforward. This grounding publication on case management helps physicians better meet the unique needs of patients who present with poor health and high healthcare-related costs, i.e., health complexity. It details the many challenges and optimal practices needed to work effectively with various types of case managers to improve patient outcomes. Special attention is given to integrated case management (ICM), specifically designed for those with health complexity. The book provides a systematic method for identifying and addressing the needs of patients with biological, psychological, social, and health-system related clinical and non-clinical barriers to improvement. Through ICM, case managers are trained to conduct relationship-building multidisciplinary comprehensive assessments that allow development of prioritized care plans, to systematically assist patients to achieve and document health outcomes in real time, and then graduate stabilized patients so that others can enter the case management process. Patient-centered practitioner-case manager collaboration is the goal. This reference provides a lexicon and a roadmap for physicians in working with case managers as our health system explores innovative ways to improve outcomes and reduce health costs for patients with health complexity. An invaluable, gold-standard title, it adds to the literature by capturing the authors' personal experiences as clinicians, researchers, teachers, and consultants. The Physician's Guide: Understanding and Working With Integrated Case Managers summarizes how physicians and other healthcare leadership can successfully collaborate with case managers in delivering a full package of outcome changing and cost reducing assistance to patients with chronic, treatment resistant, and multimorbid conditions.
Author: Teresa Treiger
Publisher: Lippincott Williams & Wilkins
ISBN: 1496319435
Category : Medical
Languages : en
Pages : 732
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Book Description
This book is about the progressive improvement of case management beyond that which it exists to that of a practice specialty focused on professionalism and collegiality across all practice settings. Our desire to produce a framework for such practice began when we connected several years ago. It was a result of a dialogue; the sharing of our stories and experiences. Separately, we were already passionate about and committed to case management excellence. Together, our vision coalesced to form this competency-based framework for advancing case management captured by an acronym which defined the essence of professional practice---COLLABORATE. We spent hours discussing the implications of a perceived epidemic involving less than productive interactions between individuals working under the title of case manager with consumers, providers, and clinical colleagues. These accumulated experiences heightened our commitment to lead much-needed change. Our conversation endured over many months as we realized a shared: Respect for case management’s rich heritage in healthcare, across professional disciplines and practice settings; Concern for those factors which devalue case management’s professional standing; Agreement that while the practice of case management transcends many representative professional disciplines and educational levels, each stakeholder continues to cling to their respective stake in the ground; and Belief of the importance for case management to move from advanced practice to profession once and for all. COLLABORATE was borne from a vision; the mandate to solidify a foundation for case management practice which combines unique action-oriented competencies, transcends professional disciplines, crosses over practice settings, and recognizes educational levels. The ultimate focus is on improving the client’s health care experience through the promotion of effective transdisciplinary collaboration. COLLABORATE recognizes the hierarchy of competencies and practice behaviors defined by the educational levels of all professionals engaged; associate, bachelors, masters and doctoral degrees across practice disciplines. Through this approach, every qualified health and human service professional has a valued place setting at case management’s ever-expanding table. Each of the competencies are presented as mutually exclusive and uniquely defined however, all are complementary and call on the practitioner to conduct work processes in a wholly integrated manner. While appearing in order for the acronym’s sake, they are not necessarily sequential. Ultimately, case management is an iterative process. When united in a comprehensive and strategic effort, the COLLABORATE competencies comprise a purpose-driven, powerful case management paradigm. The agility of this model extends to use of key concepts that include both action-oriented verbs and nouns, which are significant elements in any professional case management endeavor. To date, case management practice models have been driven by care setting and/or business priorities. Unfortunately, this exclusivity has contributed to a lack of practice consistency due to shifting organizational and regulatory priorities. However, this is only one reason for a fragmented case management identity. COLLABORATE recognizes and leverages these important influencers as critical to successful practice and quality client outcomes. Interprofessional education and teamwork are beginning to emerge as the means to facilitate relationship-building in the workplace. Through this approach, health care practitioners absorb the theoretical underpinning of intentionally work together in a mutually respectful manner which acknowledges the value of expertise of each care team stakeholder. This educational approach provides the opportunity to engage in clinical practice that incorporates the professional standards to which we hold ourselves accountable Innovative and emerging care coordination models, defined by evidence-based initiatives, appear across the industry. Each promotes attention to interprofessional practice in order to achieve quality patient-centered care. Herein lies an opportunity to demonstrate the value drawn from diverse expertise of case managers comprising the collective workforce. However a critical prefacing stage of this endeavor involves defining a core practice paradigm highlighting case management as a profession. The diverse and complex nature of population health mandates that case management intervene from an interprofessional and collaborative stance. While inherent value is derived from the variety of disciplines, this advanced model unifies case management’s unique identity. Now is the time to define and adopt a competence-based model for professional case management. COLLABORATE provides this framework. This text is presented in four sections: Section 1: Historical validation of why this practice paradigm is critical for case management to advance to a profession; Section 2: Presentation of the COLLABORATE paradigm, with a chapter to devoted to each distinct competency and the key elements; Section 3: Practical application of the book’s content for use by the individual case manager and at the organizational level; and The Epilogue: Summarizes the COLLABORATE approach in a forward-looking context. For the reader with limited time, reviewing Section 2 provides the substantive meat associated with each of the competencies. Our ultimate desire is that the COLLABORATE approach provides an impetus for all stakeholders (e.g., practitioners, educational institutions, professional organizations) to take the necessary steps toward unified practice in order to facilitate the transition of case management considered as a task-driven job to its recognition as being a purpose-driven profession. The book provides a historical validation of why this new practice paradigm is critical for case management to advance as a profession; presents the COLLABORATE paradigm, with a chapter to devoted to each distinct competency and the key elements; and covers the practical application of the book’s content by individual case managers, and at the organizational level.
Author: Diane Huber
Publisher: Elsevier Health Sciences
ISBN: 0323449026
Category : Medical
Languages : en
Pages : 544
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Book Description
Develop your management and leadership skills. Leadership and Nursing Care Management, 6th Edition maintains its AONE competencies, and features the most up-to-date, evidence-based blend of practice and theory related to the issues that impact nursing management and leadership today. A fresh, conversational writing style provides you with an easy-to-understand, in-depth look at these prevalent issues. Key topics include the nursing professional's role in law and ethics, staffing and scheduling, delegation, cultural considerations, care management, human resources, outcomes management, safe work environments, preventing employee injury, and time and stress management. UNIQUE! Chapters divided according to AONE competencies for nurse leaders, managers, and executives. Research Notes in each chapter summarize relevant nursing leadership and management studies and highlight the practical applications of research findings. Case Studies at the end of each chapter present real-world leadership and management situations and illustrate how key concepts can be applied to actual practice. Critical Thinking Questions at the end of each chapter present clinical situations followed by critical thinking questions that allow you to reflect on chapter content, critically analyze the information, and apply it to the situation. Full-color design and photos makes content more vivid. 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.
Author: Roger G. Kathol, MD
Publisher: Springer Publishing Company
ISBN: 082610634X
Category : Medical
Languages : en
Pages : 319
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Book Description
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
Author: M. Lindell Joseph
Publisher: Elsevier Health Sciences
ISBN: 0323697127
Category : Medical
Languages : en
Pages : 594
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Book Description
Develop your management and nursing leadership skills! Leadership & Nursing Care Management, 7th Edition focuses on best practices to help you learn to effectively manage interdisciplinary teams, client needs, and systems of care. A research-based approach includes realistic cases studies showing how to apply management principles to nursing practice. Arranged by American Organization for Nursing Leadership (AONL) competencies, the text addresses topics such as staffing and scheduling, budgeting, team building, legal and ethical issues, and measurement of outcomes. Written by noted nursing educators Diane L. Huber and Maria Lindell Joseph, this edition includes new Next Generation NCLEX® content to prepare you for success on the NGN certification exam. UNIQUE! Organization of chapters by AONL competencies addresses leadership and care management topics by the five competencies integral to nurse executive roles. Evidence-based approach keeps you on the cutting edge of the nursing profession with respect to best practices. Critical thinking exercises at the end of each chapter challenge you to reflect on chapter content, critically analyze the information, and apply it to a situation. Case studies at the end of each chapter present real-world leadership and management vignettes and illustrate how concepts can be applied to specific situations. Research Notes in each chapter summarize current research studies relating to nursing leadership and management. Full-color photos and figures depict concepts and enhance learning. NEW! Updates are included for information relating to the competencies of leadership, professionalism, communication and relationship building, knowledge of the healthcare environment, and business skills. NEW! Five NGN-specific case studies are included in this edition to align with clinical judgment content, preparing you for the Next Generation NCLEX® (NGN) examination. NEW contributors — leading experts in the field — update the book’s content.
Author: Hussein M. Tahan
Publisher: Lippincott Williams & Wilkins
ISBN: 1496351894
Category : Medical
Languages : en
Pages : 744
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Book Description
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
Author: U.S. Department of Health And Human Services
Publisher: Lulu.com
ISBN: 1794760350
Category : Reference
Languages : en
Pages : 136
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Book Description
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.
