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At least 19 recordsLinked to original sources
PubMed1997

Managing case management across the continuum: an organized response to managed care.

Case management is a core strategy for providing high-quality, cost-effective care in a managed care environment. Acute care case management programs most often originate as nursing-driven, hospital-based initiatives. Given the overwhelming trend toward vertical integration of health care organizations, hospital-based case management programs may be only an interim step toward a longer term strategy. Hospital and case management program leadership should consider how existing case management models can expand to meet patient and provider needs in an integrated health system or network environment. Key issues and strategies for designing a case management system based on continuum of care are described.

Case Management↗
PubMed1996

Epoetin alfa--focus on nursing case management. Case study of the anemic patient.

Case management is a multidisciplinary collaborative approach that emphasizes continuity of patient care. Nursing case management can lead to improvements in the quality of care while affording nurses the opportunity to increase their expertise, autonomy, and authority in the health care system. Treatment of the anemia of end-stage renal disease (ESRD) is used as an example to illustrate the implementation of these principles in the dialysis unit.

Anemia, Iron-Deficiency↗
PubMed1995

Cracked teeth--treatment rationale and case management: case reports.

The treatment rationale for, and successful management of, six teeth with cracks in the form of incomplete vertical fractures are reported. Further crack propagation was prevented by placement of either stainless steel orthodontic bands or aluminum or acrylic resin provisional crowns, and endodontic treatment was subsequently carried out. The teeth were restored with intraradicular amalgam cores and complete veneer crowns. The teeth were reexamined periodically for up to 3.5 years after treatment. During the period of review, all teeth remained asymptomatic.

Adult↗
PubMed1995

Utilization management, case management, and you.

Historically, most monitoring functions have been carried out by insurance companies. Monitoring costs was considered their fiduciary obligation to their customers. The exercise of this fiduciary obligation kept premiums low, while increasing or maintaining the benefit levels. Risk (the assumption of losses generated by services costing more than the income received from premiums) was assumed by the insurance company and eventually passed to the customer or the payer. Today, risk is being transferred more and more to the provider. This transfer was started by the creation of DRGs, the main purpose of which was to transfer risk from payers (insurance companies, employers, state and federal government, etc.) to provider health care organizations (physician groups, individual practitioners, hospitals, clinics, etc.).

Cost Control↗
PubMedDate not supplied

The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

Attitude of Health Personnel↗
PubMed1990

A social work practice model of case management: the case management grid.

Case management is a major component of the current mainstream of social work practice. Nevertheless, the field has failed to adequately conceptualize case management. The first step in defining case management practice is to separate it from the administrative structure that forms the context of practice. The next step is to delineate the two basic dimensions of case management--enabling and facilitating. The role of the social work case manager is to integrate formal systems of care with the activities of families and primary groups. Case management practice focuses on enabling individuals and primary groups to reach their full potential and on facilitating more effective interaction with the larger social environment. The case management grid illustrates how social work practitioners integrate enabling and facilitating into their practice approaches.

Humans↗
PubMed1998

Research directions for case management.

Case management is a worldwide phenomenon and depending on the particular country's organizational framework of the health and social system, many models have been developed. The definitions of case management vary, but all of the models being developed aim to provide holistic quality care that is cost-effective. Reviewing the various components of case management is important because they contribute to the success or failure of providing quality, cost-effective care. The geographical setting where case managers work (i.e., hospitals or community/home), and the level of fiscal authority given to the case managers are two important components of case management models. Whether there is a conflict between case managers acting as advocates of clients while at the same time being the gatekeeper of funds is an area that needs exploration. The question is can the two notions be "married" as opposed to being inherently conflicting, and can case managers act in the best interests of the clients. There are many research directions for case management, including which aspects of the model ultimately have positive results for the client and health and social system.

Case Management↗
PubMed1994

The managerial nature of case management.

Case managers have been viewed as engaging in direct practice, community practice, or both. This article offers a third view: Case managers also engage in the practice of management. Employing Mintzberg's seminal research on chief executive behavior, the authors argue that case managers' work is similarly characterized by brevity, variety, and fragmentation. Case managers perform the 10 roles developed in Mintzberg's original study. These roles are divided into three groups: interpersonal, including figurehead, leader, and liaison; informational, including monitor, disseminator, and spokesperson; and decision-making, including entrepreneur, disturbance handler, resource allocator, and negotiator. Case managers' tasks associated with each role are presented. Considering their work as managerial in nature will help case managers more effectively assist clients in goal achievement.

Health Resources↗
PubMed1997

Personal assistance services and case management.

Case managers can serve a vital role in the coordination and support of consumer-driven personal assistance services (PAS) for people with disabilities. Personal assistants provide services such as assistance with mobility needs, transferring in and out of a bed or wheelchair, bathing, dressing, grooming, toileting, preparing meals, check writing, and communication interpretation. Maximum independence and autonomy are often achieved when disabled people manage the services that they need. By focusing case management on doing what the individual directs, the case manager can enhance independence, autonomy, and accommodation. In response to needs identified by its members, the Paralyzed Veterans of America (PVA) began to develop a comprehensive PAS training program for institutions, agencies, families, and individuals. The Independent Living Training Program is based on an approach to PAS that incorporates a case management model that supports the principles of consumer empowerment and self-determination.

Activities of Daily Living↗
PubMedDate not supplied

HIPAA Business Associate Contracts: the value of contracts for case managers.

Case Managers are in the middle of the upcoming HIPAA regulation changes, with the issuance of the Final Privacy Rule. Every case obliges case managers to work with Individually Identifiable Health Information (IIHI) and Protected Health Information (PHI). The purpose of this article is to provide case managers in all practice settings with a clear understanding of a "Business Associate," of a "Covered Entity," and of the specifics of a Business Associate Contract. This information will demonstrate how case managers can benefit from the use of these contracts in their business life. As an essential component of an organization's compliance plan, Business Associate Contracts can become a sword or a shield. This article is particularly helpful to case managers in independent practice, as well as those who work for Covered Entities.

Case Management↗
PubMedDate not supplied

Communication: an outcome of case management.

Case management is a healthcare delivery model emphasizing coordination and networking of patient care services across multidisciplinary providers and various care settings. This requires effective communication to overcome traditional barriers to information exchange. This study investigates communication as an outcome of case management. The classic communication model of sender-message-channel-receiver is used as a conceptual framework. Using a closed medical record review, the amount and type of referral information exchanged between a hospital using a case management model to coordinate care and a home health agency accepting the case-managed patient is described. In addition, the influence of selected organizational and medical condition factors on communication is explored.

Case Management↗
PubMedDate not supplied

Patterns of health resource utilization, costs, and intensity of need for primary care clients receiving public health nursing case management.

Case management has been promoted as a managed care strategy that improves quality of care and contains costs. Health resource utilization patterns and associated costs were examined for a generalized primary care population receiving a public health nursing model of case management intervention during a 30-week period. Subjects were referred by providers practicing in an academic health science center and included two client subsamples: chronically ill adults and younger families requiring health maintenance. Health resource utilization patterns and associated costs were examined in relation to intensity of need for care levels as determined by the Community Health Intensity Rating Scale. Results of this pilot study suggest that during public health nursing case management intervention, health resource utilization patterns changed from the preintervention period. Total health resource utilization costs were correlated with care needs related to health management behavior of the chronically ill.

Adult↗
PubMed1998

The Omaha System: a model for describing school nurse case management.

Case management is a key role for school nurses to employ in effecting positive outcomes for students in both health and education. The purpose of this paper is to describe the Omaha System and demonstrate its usefulness as a tool for school nurse case management. A case study model was used to analyze the practice of a single school nurse. During the 1995-1996 school year, the Omaha System helped a school nurse to identify students' health problems utilizing the Problem Classification Scheme, and the Intervention Scheme helped identify the nursing interventions employed. The Problem Rating Scale for Outcomes is also discussed in relation to this particular school nurse's practice.

Case Management↗
PubMedDate not supplied

Defining case management.

Case management is a frequently used term in nursing; however, it is not easily defined. The discussion that follows examines the various meanings of case management and the roles of the case manager.

Humans↗
PubMed1992

Adolescent pregnancy and early intervention programs benefit from case management.

Case Management methods are being adapted to effectively serve two vulnerable populations: pregnant and parenting adolescents, and infants and toddlers with disabilities of developmental delay and their families. This article describes the case management model developed by California's Adolescent Family Life program and discusses issues related to providing family-centered, community-based case management in early intervention programs.

Adolescent↗