News Letters (New Definition)

Winter 2016– Vol 30 No 3. Why Become Certified in Case Management?
Certification is generally thought to indicate expertise as either a staff case manager, or in the
case of the (CMA-C) Case Management Administrator-Certified™, as a leader or administrator of
case management programs including Inpatient and Outpatient, and Transition Case Managers.
The exam is also geared to case management administrators on the payer-side of the industry.

 

 

Winter 2016

Fall 2016– Vol 30 No 2. Care Management in the Era of Bundled Payment for Care Initiatives.

Care management’s place in healthcare has never been more vital than now. There are a high
degree of government and payer initiatives aimed at reducing healthcare spending and cost,
and improving quality and efficiency. Based upon the nature of core functions performed by
care management professionals, they are poised to be instrumental in effecting the outcomes of
these initiatives within a variety of healthcare settings and in the community

 

 

Fall 2016

Summer 2016– Vol 30 No 1. 15 Best Practices in Acute Care Case Management

After 30 years of not only pioneering provider-side case management, but paying attention to Case Management practice, it is time to list at least 15 best practices.

 

 

Summer 2016

Winter2015– Vol 29 No 3. Readmission/ED Revisit Checklist: Prevention Strategies

 

 

Winter 2015

Fall 2015– Vol 29 No 2. The Overwhelming Moral and Ethical Reality of Care Management Practice

The traditional primary ethical duty of every nurse and social worker is to the patient and family; this has been true since the origin of the professions.  Yet Care Managers are commonly employed by facilities or organizations in which financial and regulatory constraints limit the resources that are available for provision of care.  Additionally, the resources available for care vary according to the financial circumstances (including health care coverage) of the patient, in itself a circumstance that is discordant with the core values of health care.  Policies and regulations dictate how much care can be delivered in which setting and by which professional.  Clinical decisions must be weighed within community and organizational contexts.   The importance of patients’ and employees’ individual rights must be balanced with the survival of the institution or organization within the community. Article includes 5 remedies.

 

Fall 2015

Spring 2015– Vol 29 No 1. Predicting ED Case Management: the Next 5 Years

Due to the wide variation in ED Case Management, CCM conducted an opinion survey beginning in 2013 at an ED conference, once in 2014, and following a webinar in 2015.  All 63 respondents were ED case management professionals.  There EDs ranged greatly in be size, from critical access hospitals to large academic medical centers.  read on to see what we discovered.

Spring 2015

Fall 2014– Vol 28 No 1. The “Magic” of Interviewing Prospective Hospital RN Case Managers – by Linda DeBold, ARNP, CMAC, Consulting Associate, The Center for Case Management.

Don’t you wish you had a crystal ball when it comes to hiring a new RN case manager? Ifonly there was a blueprint to follow! Let me tell you from experience that the hiring processis difficult at best these days with so many legal restrictions. Internal staff nurse candidatesthat you think you know well can be difficult because they may have a distorted concept ofwhat really a case manager does. You certainly do not want to put in several weeks to train a“novice” case manager, to then find his or her concept of the role was not based on therealities of the role

Fall 2014

Spring/Summer 2012 – Vol 27.      No 1 – “Highly-Reliable Hospital Case Management : Defining      Patient/Family-Centered Standards.” What Highly-Reliable Means      – According to Webster, the adjective “reliable” means “consistently good      in quality or performance; able to be trusted”. Going one degree further,      “Highly-reliable” is the new phrase for describing hospitals that provide      consistent delivery of safety and quality. Dr. Mark Chassin, MD, FACP,MPP,      MPH, President and CEO of The Joint Commission believes that the concept      of high reliability will be a game changer if safe and effective processes      are executed and sustained over long periods of time…..

Spring/Summer 2012

Spring/Summer 2011 – Vol 26. No 1 – “Everything I Learned from Case Management I Used…As a Camp Nurse!” : With summer finally on the way, I am fondly remembering my one extremely hot week as an infirmary nurse at an all- girls’ camp in the Berkshire Mountains of Western Massachusetts. That summer my daughter was a head counselor, and so I took the challenge of stretching from my comfortable knowledge base of case management to a new role as hands-on nurse after many years without that pleasure. Usually learning goes the other way around-from life experiences to case manager, which I consider one of the most complex roles in health care or maybe anywhere else. But for this challenge, the learning went from case management to camp nurse, only to confirm that what we do in case management is universal and the principles are sound.

Spring Summer 2011

Winter/Spring 2010– Vol 25. No 1 online edition – “Giving Nursing What it Needs: A Case Management Checklist”: Whether assigned by unit, service, or mixture of deployment models, case management nurses and social workers have a responsibility to the nurses who share their patients. Although this may seem obvious, clarifying the actual deliverables from case management services to nursing colleagues might make the relationship between the two groups more collaborative and hence, more satisfying. It is important to differentiate what nursing needs to support its own responsibilities versus what nursing WANTS to reduce its legitimate workload.

Winter/Spring 2010

Spring/Summer 2009 – Vol 24. No 1 online edition – “The Six Core Functions of Case Management Services”: Case Management services continue to evolve as they touch almost every operation in the hospital and move into the center of the decision-making around and with each patient and family. In many ways, case management as an overall process of connecting resources to needs has not substantially changed over the last 200 year…..

Spring/Summer 2009 - Vol 24. No 1

Spring/Summer 2008 – “Setting the Gold Standard for Social Work: Validating FTEs for Highest Quality Service”: With the ever changing health care landscape, Social Work departments find themselves in precarious conditions to deliver high quality care while effectively managing the operational costs of the organization…..

Spring/Summer 2008

Fall 2007 – “Community Case Management: A Caring Blend of Heart, Art and Science”: The Community Case Management program is an integral part of Overlake’s Senior Care program. Senior Care is a multifaceted program designed to mobilize the vast array of health resources available through Overlake Hospital Medical Center and Eastside physicians…..

Fall 2007

Spring/Summer 2007 – “It’s Not the ‘Notice’, It’s the ‘Message’ that Matters: Addressing Patients’ Rights to be Informed of Discharge and Rights to Appeal” On July 1, 2007 a revision of the practice of notifying Medicare Beneficiaries of their discharge rights became effective. Hospitals are required to use a two step process to assure that Medicare Beneficiaries can exercise their rights……

Spring/Summer 2007

Fall/Winter 2006 – “Programs of Care: Governing Clinical Practice Across Time and Place” What would you as an administrator give to have the whole organization at all levels working together to improve the outcomes of patient care, not only inside but outside of your walls?

Fall/Winter 2006

Spring 2006 – “Job Descriptions Essential for Hospital Physician Advisors” Read on as to why the Physician Advisor/Director Case Management services is a fundamental role in both payer and provider organizations.

Spring 2006

Summer 2006 – “Social Power and Influence of a Case Management Service: Invisible No Longer” Describing Case Management can be very difficult. However if we use the range of Social Power and Influence inherent to the role, Case Management services will be better able to negoiate and meet targets.

Summer 2006

Winter 2006 – “Careless Care: The Slippery Slope Down Safety Mountain” Ensuring patient safety is at the forefront of initiatives in health care, seemingly as an huge endeavor as a mountain to be scaled. Read one patients true story presented as a chance to study the slope of events.

Winter 2006

Fall 2005 – “CareGraph™ Clinical Progressions: The Flexible, Visual Clinical Path!” An outcome evaluation tool that describes incremental changes from 0-4 in the clinical status of acutely ill patients, organized by Assessment Category and time-frame, enabling a rapid visual comparison of clinical progressions and their variations.

Fall 2005

Summer 2005 – “The Most Vulnerable Unit: Crisis on the Horizon”: tackles the thorny issue of identifying and turning around a vulnerable unit before a crisis occurs.

Summer 2005

Winter 2005 – Upgrading Case Management to Prevent “Maxing Out”: Takes a close look at the role of case management in acute care and provides 10 recommendations to keep these departments producing significant results.

Winter 2005

Summer 2004 – Capitalizing on Social Work Expertise in Sentinel Events: Reviews the trend data of Sentinel Events and how Social Workers can provide leadership to prevent these occurances

Summer 2004

Winter 2004 – “Looking Under the Sheets: The Case Manager’s Practice of Direct Contact with Patients and Families” An argument that direct contact with patients should be a fundamental part of the case management role.

Winter 2004

Fall 2003 – “Integrated care pathways: eleven international trends.” Appeared in Journal Of Integrated Care Pathways

Fall 2003

Summer 2003 – “Planning for the Day, the Pay, the Stay and the Way.” Clearing up the ambiguity of Case Management-related duties.

Summer 2003

Winter 2003 – “Healthcare, 2003 : Teflon(r) Managing Jello(r).” There is a growing crisis in which the essential knowledge workers cannot keep up with the knowledge or the work.

Winter 2003

Summer 2002 – Getting to “Yes” When Payers Say “No” – The Importance of a Strong Denial Management Program

Summer 2002

Spring 2001 – DataMap(TM): A Dashboard to Guide the Executive Team

Spring 2001

Winter 2001 – Where Process Meets Practice: The New Physician UR Advisor

Winter 2001