The Leader S Guide To Hospital Case Management Book in PDF, ePub and Kindle version is available to download in english. Read online anytime anywhere directly from your device. Click on the download button below to get a free pdf file of The Leader S Guide To Hospital Case Management book. This book definitely worth reading, it is an incredibly well-written.
The Leader's Guide to Hospital Case Management by Stefani Daniels,Marianne Ramey Pdf
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.
Core Skills for Hospital Case Managers by Tony Cesta,Beverly Cunningham Pdf
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 by Suzanne K. Powell,Hussein M. Tahan Pdf
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
CMSA Core Curriculum for Case Management by Anonim Pdf
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.
The Case Manager's Survival Guide by Toni G. Cesta,Hussein M. Tahan Pdf
Revised, updated, expanded edition of essential book for case managers in nursing, healthcare and other professional disciplines New information on the ACA, value-based purchasing, accountable care organizations, emerging reimbursement methods, transitions of care, changing accreditation standards and much more A proven textbook for university courses, CCM exam prep, and continuing education Hundreds of case studies, finance formulas, practical pointers and sample problems The third edition of this important book adds over 10 years of new data, facts and experience needed by professional case managers, administrators and students of case management. This new edition incorporates the impacts of the Patient Protection and Affordable Care Act, value-based purchasing methods, care coordination strategies, transition planning, and case management software. Like the previous editions, the book is written to assist the professional and student, especially in the field of nursing, with practical guidance for understanding and mastering the techniques of managing cases in multiple healthcare settings: pre-acute, acute, and post-acute. At once practical and comprehensive, the new and expanded edition provides recent financial, legal and medical information required by case managers to succeed in the evolving environment of healthcare delivery. The result is an essential resource for individuals and interdisciplinary teams from many professional backgrounds, who can use the know-how in this volume for coordinating care, containing costs, and improving quality and the patient experience. The Case Manager's Survival Guide is also a proven textbook, used by hundreds of instructors and students in university and continuing education courses, as well by those preparing for the CCM exam.
The Case Manager's Handbook by Catherine M. Mullahy Pdf
Written by renowned author Catherine Mullahy, The Case Manager's Handbook, Fourth Edition is the ultimate how-to guide for Case Managers. It is designed to define good case management, examine the case management process, and present practical procedural information. The Fourth Edition has been completely revised and updated with new references and pertinent information. This book is an excellent daily reference or can be used as a training guide for new case managers, or a teaching tool for client groups. Accompanied by a CD-ROM and a FREE Student Study Guide is available online.
CMSA Core Curriculum for Case Management by Hussein M. Tahan,Teresa M. Treiger Pdf
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
COLLABORATE(R) for Professional Case Management by Teresa Treiger,Ellen Fink-Samnick Pdf
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.
The Case Manager’s Handbook by Catherine M. Mullahy Pdf
"The Case Manager's Handbook, Sixth Edition is an indispensable guide for case managers. Presented in an accessible and conversational style, this practical resource helps case managers learn the fundamentals, study for the Certified Case Manager exam, and advance their careers after the exam. Completely updated and enhanced with information on the latest developments affecting case management, it reflects the rapidly changing healthcare landscape, including the significant effects of the Affordable Care Act."--Back cover.
The Integrated Case Management Manual by Roger G. Kathol, MD,Janice S. Cohen, PhD , CPsych Pdf
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
Lean Daily Management for Healthcare by Brad White Pdf
You likely don’t need any more tools, programs, or workshops to improve your hospital. What you need is a simple and consistent approach to manage problem-solving. Filling this need, this book presents a Lean management system that can help break down barriers between staff, directors, and administration and empower front-line staff to resolve their own problems. Lean Daily Management for Healthcare: A Strategic Guide to Implementing Lean for Hospital Leaders provides practical, step-by-step guidance on how to roll out Lean daily management in a hospital setting. Ideal for leaders that may feel lost in the transition process, the book supplies a roadmap to help you identify where your hospital currently is in its Lean process, where it’s headed, and how your role will change as you evolve into a Lean leader. Illustrating the entire process of implementing Lean daily management, the book breaks down the cultural progression of units into discreet, objectively measurable phases. It identifies what leaders at all levels of the organization must do to progress units into the next phase of development. Complete with case studies from different service areas in the hospital, the book explains how to link problem-solving boards together to achieve meaningful and measurable improvements in: the emergency department, the operating room, discharge times, clinics, quality, and patient satisfaction. After reading this book you will understand how consistent rounding, a few whiteboards, pen-and-paper data, and a focused effort on working the Plan-Do-Study-Act cycle can help you build a common problem-solving bench strength throughout your organization—establishing the framework upon which future improvement can be built.
The Hospital Guide to Contemporary Utilization Review by Stefani Daniels,Ronald L Hirsch, MD, Facp, Chcqm,Ronald L. Hirsch Pdf
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
Laura J. Fero,Charlotte Anne Herrick,Jie Hu (Ph. D.)
Author : Laura J. Fero,Charlotte Anne Herrick,Jie Hu (Ph. D.) Publisher : Jones & Bartlett Publishers Page : 382 pages File Size : 43,7 Mb Release : 2011 Category : Medical ISBN : 9780763771607
Introduction to Care Coordination and Nursing Management by Laura J. Fero,Charlotte Anne Herrick,Jie Hu (Ph. D.) Pdf
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.
A Guide for Nurse Case Managers by Charlotte Cox Pdf
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.
