This practical, hands-on guide includes vital information every case manager and administrator of a case management program need to be successful. A useful resource for working in the changing face of healthcare, it addresses case managers in all settings with an emphasis on nurse case managers and their role in providing patient care and containing costs. Focusing on the nuts and bolts aspects of case management, it discusses the operations of case management programs based on the authors first hand experiences.
1. Introduction to Case Management 2. Financial Reimbursement Systems 3. Case Management Models 4. Role of the Nurse Case Manager 5. Utilization Management 6. Transitional Planning 7. Disease Management 8. Skills for Successful Case Management 9. Nurse Case Managers Documentation 10. Hiring Case Managers: Role of the Candidate and the Interviewer 11. Curricula and Certification in Nurse Case Management 12. Developing Case Management Plans 13. Quality Patient Care 14. Measuring the Effectiveness of a Case Management Model 15. Linking JCAHO to Case Management 16. Legal Issues in Case Management 17. Application of Legal Concepts to Case Management Practice 18. Ethical Issues in Case Management 19. Internet Resources and Case Management
APPENDICES A. Community Nurse Case Management Problem List and Plan of Care B. Community Nurse Case Management Intervention Flow Sheet and Problem Rating Scale for Outcomes C. Community-Based Wound Care Pathway and Flow Sheet D. Home Care Plan for Congestive Heart Failure and Hypertension E. Sub-Acute Care E-1 Clinical Guideline for Short-Term Sub-Acute Admissions E-2 Referral Assessment Form E-3 Sub-Acute Data Collection Tool F. Long-Term Care Resident Assessment Instrument Case Study and Care Plans G. Pre-Printed Order Sets H. Documentation Guides for Physicians I. Case Manager - Inpatient J. Case Manager - Admitting Office K. Case Manager - Emergency Department L. Case Manager - Community M. Physician Advisor N. Guide for a Case Managers Competency-Based Performance Appraisal O. Performance Management Form - Case Coordinator Glossary Index
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