Competency Evaluation Tools for Case Management Professionals, Second Edition
Karen Zander; RN, MS, CMAC, FAAN
Capture the best ideas, theories, and strategies in case management practice to move it from a JOB to a PROFESSION.
This second edition of a best-selling toolkit helps organizations evaluate case management professionals based on their individual skills and strengths.
Competency Evaluation Tools for Case Management Professionals, Second Edition, takes a real-world approach by looking at the functions case managers actually perform and delivers a strong foundation to develop performance appraisals, job descriptions, and sequence training.
Designed by The Center for Case Management with the help of more than 50 national case management experts, this second edition is updated with competency assessment tools in several new areas within the expanding case management arena.
You’ll assess competencies and design a case manager’s role around the functions at which the individual excels. Case Management Evaluation Tools for Case Management Professionals, Second Edition, includes competency evaluations for:
- Case Management Administrators
- Access and/or Liaison
- Utilization Review
- Care Coordination
- Discharge Planning
- Disease Management
- Clinical Social Work (MSW)
- Physician Advisors/Medical Directors, Case Management
- Emergency Department Case Managers
- Clinical Documentation Improvement Specialists
- Utilization Review/Discharge Planning/Care Coordination (combined roles)
This book helps you:
- Define competency in relation to case management
- Differentiate between the three domains of competency evaluated in this toolkit
- Explain the challenge of evaluating case management professionals
- Identify the distinct functions that make up the case management role
- Analyze an individual’s performance based on his or her competency level
- Recognize how to encourage an individual to advance from one competency level to the next
Use these competencies to:
- Clarify job descriptions
- Integrate into performance appraisals
- Restructure your staffing and processes
- Build case management-related curriculum for in-service and academic offerings
- Encourage staff to develop case management from a job to a profession
Hospital Case Management Models: Evidence for Connecting the Boardroom to the Bedside
Karen Zander; RN, MS, CMAC, FAAN
Bridge the gap from the boardroom to the bedside with the right case management model
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 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.
This user-friendly guide will help you:
- Choose a case management model based on best evidence and experience that will meet your organizational needs
- Streamline your case management department and responsibilities to ensure quality patient care, increase staff and patient satisfaction, and reduce cost of care delivery
- Understand how to implement the model at the point of care with helpful Bedside Bulletins found at the end of each chapter
- Organize your model by using the included evidence-based tools, decision trees, and case examples
Finally—a resource that combines theory, evidence, and practical how-to tips!
Linking everything in a logical fashion, this new resource combines the important theory behind each case management model with practical Bedside Bulletins that care managers can implement at the point of care. Found at the end of each chapter, these Bedside Bulletins deliver tips and tools to put your model into practice at the bedside.
Plus, this book’s innovative data dashboard tool makes it easy for case management departments to outline their contributions to the four main goals of any healthcare organization’s board of directors:
1. Financial stability
2. Quality care and patient satisfaction
Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition
Kathleen Walsh, RN, PhD
Karen Zander, RN, MS, CMAC, FAAN
Christina Boyd, BA, MPH
Sean Burton, CCEMT-P
Sarah B. Carignan, BA, MBA
Mary G. Daymont, RN, BSN, MSN, CCM
Bonnie M. Geld, MSW
Patricia B. Green, LMSW
Deborah Hale, CCS, CCDS
Ann Marie Hill, MSW, LiCSW
Eileen Hughes, RN, MBA
Joan Stack Kovach, RN, MS, PC
J. Michelle Moccia, MSN, RN, ANP-BC, CCRN
Chris Nesheim, RN, MS, CMAC
Suzanne O’Connor, RN, MS, CS
Maria Seavey, RN, BSN
Sallie A. Selfridge, LBSW
Andrea Snyder, RN, CCRN
Rowena (Ricki) Stajer, RN, MA, CPHQ
Dawn Williamson, RN, MSN, PMHCNS-BC, CARN-AP
From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency D
epartment 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
The new edition includes:
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.
Social Work: Strength-Based Practice in Hospital Case Management
Bonnie Geld, MSW
Shawna Grossman Kates, MSW, MBA, LSW, CMAC
The publication Social Work: Strength-Based Practice in Hospital Case Management, (www.hcpro.com), authored by SSWLHC Past President, Shawna Grossman Kates, LSW, MSW, MBA, CMAC and Bonnie Geld, MSW, was borne from desire to fill a glaring a gap in the literature addressing social work practice in hospital-based case management.
Several expert SSWLHC members contributed chapters and highlighted examples that move this from a theoretical compendium to a practical handbook. It is a meaningful guide, whether the reader is a social work leader, front line social worker, or a non-social worker with responsibility for social work programs in their setting.
Social workers and case managers work to identify resources to meet primary social welfare needs; at their core, they demonstrate key skills of assessing, brokering, engaging, partnering, risk managing, and problem solving. Case management directors do not always know how to align social workers and RN case managers to: 1) assure resources to maximize care coordination, discharge planning, revenue cycle, team collaboration, transitions in case, and other case management functions, and 2) capitalize on the strengths of social work in demonstrating measurable outcomes.
Click here to purchase the publication.
Congratulations to Authors: Bonnie Geld and Shawna Grossman Kates, and all the Contributors including several SSWLHC members:
* Matt Boettcher, LMSW-AP, LCSW, MSW
* Linda Brandeis, ACSW, LICSW
* Eleni Carr, MBA, LICSW
* Scott Ferguson, MSW, LCSW, ACM
* Jeanette Foster, MSW, LISW-S
* Theresa E. Jenner, MSW, LICSW
* Jill Karnes, MS, MSW, LISW-S
* Dara Kates Katz, LCSW, ACSW
* Evelyn Mascareñas, ASW
* Lori McCullough, MSW, LISW-S, C-ASWCM
* Renee Michelsen, MSS, LCSW
* Lawrence C. Pellegrini, MSW, MPA, and PhD candidate
* Nancy Shendell-Falik, RN, MA
* Roy Sittig, MD, SFHM
* June Stark, RN, BSN
The Hospital Case Management Orientation Manual
Peggy Rossi, BSN, MPA, CCM
Reviewed by Karen Zander RN, MS, CMAC, FAAN
The Hospital Case Management Orientation Manual Guide is a comprehensive resource that supplements 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.
Table of Contents
Chapter 1: Case Management Basics
Chapter 2: Factors Influencing Case Management and Its Processes
Chapter 3: Healthcare Funding
Chapter 4: Utilization Review and Utilization Management
Chapter 5: Letters, Denials, and Appeals
Chapter 6: Care Coordination
Chapter 7: Transfers, Levels of Care, and Transition Planning
Chapter 8: Home Health, Hospice, and Other Home Care Services
Who should read this book?
- Case manager
- Director of case management
- Clinical documentation specialist
- Director of clinical documentation improvement
- Chief financial officer
Review on CM Orientation Manual: ” Thanks so much for letting me review The Hospital Case Management Orientation Manual- what a reference! It covers everything and would make a comprehendsive template for any orientation program and have used it for my client”: Irene Hadley RN, BSN, MA
Case Management Models: Best Practices for Health Systems and ACOs, Second Edition
Karen Zander, RN, MS, CMAC, FAAN
The role of case management in healthcare settings is continuously evolving to meet the needs of patients and manage the quality, financial, and legal risks health systems and accountable care organizations (ACO) face. Case Management Models: Best Practices for Health Systems and ACOs offers insight into how to structure case management models across the continuum of care to address these needs and risks. Definitions and rationale for fundamental models, including dyad and triad, are provided to illustrate the needed resources and recommended structure. Guidance on case management deliverables and outcomes is also included to demonstrate the value of case management.
This book explains the differences between case management and social work and the ways in which case management functions have evolved over time. Rationale for providing case management services in health systems and ACOs is also included along with suggestions for case management reporting structures. Whether your healthcare organization has an existing or developing case management department, this resource can help you select an appropriate model and seek staff with skills best suited to help you reach your goals.
This book will help you:
- Describe how case management professionals are accountable for deliverables
- Determine which patients and families need case/care management across the continuum
- Decipher how many social workers and RN FTEs are needed at each level of care
- Explain how to use cost-benefit analysis to identify the best model for an organization
- Discuss the various ways of classifying case management models used in health systems
- Discuss how case management functions have evolved
- Describe the precursors and rationale for health systems to establish case management services
- Identify the seven fundamental components of case management models
About the Author:
Karen Zander, RN, MS, CMAC, FAAN, president and CEO of The Center for Case Management in Wellesley, Massachusetts, has more than 40 years of healthcare experience. In this role, she serves as a consultant and educator to hospitals, physicians, healthcare systems, and software, pharmaceutical, and consulting companies worldwide for the development of tools, roles, and systems to support provider-side control of cost and quality.
Zander previously was associated with New England Medical Center Hospitals (now Tufts Medical Center), where she served in multiple roles, including organizational development specialist in the nursing department, director of consultation in the Center for Nursing Case Management, inpatient/day hospital psychiatric service nurse leader, and staff education instructor.