Case Management Flashcards
What is the purpose of case management?
coordination of patient care over time using a combination of health and social services to meet the individual patient needs.
What are the goals of a case manager?
(case management care model)
collaborate, assess, plan and evaluate
patient/family centered, patient advocate, address health needs
patient education and communication
promote safety, quality care and cost effective outcomes
Who is a case manager?
social worker, nurse with advance degree and significant clinical experience
What does patient navigator mean?
to help people navigate complex health care
What does transitional care mean?
facilitate effective transitions for ill patients to ensure good communication across all settings/providers
Who do case managers care for?
everyone from pregnant women, to babies and children throughout their lifespan, to adults and older adults, all the way to palliative care. they may work very closely with families that have a child/children with life long illnesses or chronic conditions
What settings do case managers work in?
- outpatient/primary care office
- at home, or in nursing homes
- hospital settings
- with military and veterans
- health insurance companies
- with lawyers and they also handle workers comp
True or False: Case managers participate in direct care of the patient?
False.
case managers round with doctors and nurses to plan care for expected discharge from the hospital, they recognize the need for consultations, referrals, transportation or orders for things such as oxygen that the patient may need and plan it out for them.
How many patients is a case manager typically assigned to?
10-15 patients from pre admission through discharge.
What is critical/clinical pathways?
A clinical pathway is a “task-oriented care plan that details steps to follow in the care of patients. It describes the patient’s expected clinical course
It’s addresses common medical diagnosis and patient problems and the interventions required for desired outcomes.
“Care Map”
How are variances used in clinical pathways?
variances identify deviations from the pathway
clinical pathway analyzes and tracks variances that help determine if the plan needs to be revised. (investigate and determine problems and changes)
What are the specific components of clinical pathways?
- physical assessments
- labs and diagnostic tests
- medications
- procedures
- safety
- nutrition
- education
- discharge planning
- potential triggers for deviations from the plan.
What are the key responsibilities of a case manager?
- assess patient, homes and communities
- coordinate and collaborate with other health professionals to plan care and discharge
- utilize clinical pathways
- monitor patient progress and evaluate the outcome.
