Case management is a relationship-based profession that benefits health systems, patients, colleagues, and case managers. Establishing strong relationships with representatives from the long-term care continuum, including skilled nursing facilities, rehabilitation centers, memory care units, and assisted living and independent living communities, is important for case managers.
Challenged with employing enough staff in case management departments, the need for expertise in every role, and the increased requirements from payers, case management leaders are evaluating centralizing utilization review. This centralization carries both benefits and challenges, some of which are amplified because of the current healthcare climate.
Program allows case managers to provide ongoing patient oversight
January 6, 2021
As telemedicine use increases, case management professionals can harness its benefits to improve outcomes and provide a better experience for patients and physicians. COVID-19 played a large part in the increase as providers worked to minimize exposure to the virus. However, many patients still need proper monitoring.
Director explains how much things changed in the last year
January 6, 2021
Case management leaders have been navigating another COVID-19 case surge. Angie Roberson, MSN, RN, ACM-RN, director of case management at Spartanburg Regional Healthcare System in Spartanburg, SC, works in one of the worst-hit counties in one of the worst-hit states during the late 2020 and early 2021 surge of COVID-19 that swept across the United States.
A healthcare organization’s Medicare Bundled Payments for Care Improvement Advanced (BCPI Advanced) program resulted in lower hospital readmission rates. The program reduced readmission rates from 30% to 19%.
The new COVID-19 vaccine provide good news for a pandemic-weary healthcare world, offering case managers and other hospital professionals an opportunity to become vaccinated against COVID-19. Case managers should expect uncertainty about how the first vaccines are distributed.
Many Americans and healthcare workers have doubts and skepticism about the first vaccines for COVID-19, despite the need for a rapid end to the pandemic surge that began to overflow hospitals before the December holidays. In hospitals that have mandated a COVID-19 vaccine for all staff, it is a good idea to communicate to employees why they should be vaccinated.
As the COVID-19 vaccines are rolled out to U.S. healthcare organizations, there will be challenges in access, logistics, and maintaining infection prevention practices. The first step is determining which employees are eligible for the first phase of the vaccine rollout.
Before pediatric psychiatric patients are discharged from the ED, carefully document the visit and create a follow-up plan with a primary care physician or mental health professional. For patients presenting with suicidal ideation, a social worker or mental health clinician should develop a safety plan.
Every day, case managers face pressure to achieve optimal outcomes in a multitude of scenarios. At the core of each case is the patient’s understanding of medical care, their ability to think critically, make decisions about their care, and use good judgment. Capacity, competency, coping, and choice are the core considerations every case manager should examine with each patient.