COMPREHENSIVE INTRODUCTION TO CASE MANAGEMENT-SECTION 1-INTRODUCTION

Course overview

OBJECTIVES 1. Discuss the history of Case Management and Critical Pathways 2. Describe the issues involved in choosing a case management tool 3. Explain the benefits of Case Management 4. Discuss the various types of case management 5. Compare / contrast hospital-based/acute care models of case management, community-based case management models, and chronic care case management 6. Explain managed care models and case management 7. Explain and apply the Case Management Process 8. Discuss the interplay between the case management process, utilization management process and transitional 9. Describe the various roles played by case managers and identify the roles of the case manager in varied settings OUTLINE Chapter 1: Introduction to Case Management A. USING THIS GUIDE B. HEALTHCARE INDUSTRY IN CRISIS C. HISTORY OF CASE MANAGEMENT Definition of Case Managament Case Management and the Role of Case Manager Case Management as an outcomes Model D. CHANGES IN REIMBURSEMENT: THE DRIVING FORCE BEHIND CASE MANAGEMENT E. CONTINUOUS QUALITY IMPROVEMENT AND CASE MANAGEMENT Move from Team to Primary Nursing Breakdown of Primary Nursing Early Hospital-Based Case Management F. EARLY COMMUNITY-BASED CASE MANAGEMENT G HISTORY OF CRITICAL PATHWAYS H. CASE MANAGEMENT PLANS TODAY I. MULTIDISCIPLINARY CARE PLANNING J. CHOOSING A CASE MANAGEMENT TOOL K. PHYSICIAN SUPPORT L. BENEFITS OF CASE MANAGEMENT M. INTERDISCIPLINARY TEAM N. CHANGE PROCESS O. MANAGED CARE Chapter 2: Case Management Models A. TYPES OF CASE MANAGEMENT B. HOSPITAL-BASED/ACUTE CARE MODELS C. COMMUNITY-BASED CASE MANAGEMENT MODELS D. CHRONIC CARE CASE MANAGEMENT E. LONG-TERM CARE CASE MANAGEMENT F. MANAGED CARE MODELS AND CASE MANAGEMENT G. DESIGNING CASE MANAGEMENT MODELS H. SETTING UP THE CASE MANAGEMENT PROGRAM Chapter 3: Role of the Case Manager A. CASE MANAGEMENT PROCESS B. VARIOUS ROLES PLAYED BY CASE MANAGERS C. ROLES OF THE CASE MANAGER IN VARIED SETTINGS D. THE SOCIAL WORKER AS CASE MANAGER E. THE ADVANCED PRACTICE NURSE AS CASE MANAGER