Chapter 8 Part 3 - Continuum of Care: Steps to Success

Question 1

___________ Initiated when the patient’s physician contacts a healthcare organization to schedule an episode of care service

___________ - Case manager may contact the patient’s payer to confirm that all of the necessary pre-admission authorizations have been obtained and that the payer will pay for the services

Answer 1

Step 1—Perform pre-admission/pre-authorization care planning

Question 2

Case manager will review all information to confirm that the patient meets admission criteria

Answer 2

Step 2—Perform care planning at the time of admission

Question 3

Case manager periodically reviews the patient’s progress throughout the entire episode of care to confirm that the patient meets continued-stay criteria

Case manager continuously monitors the patient’s acuity level and requirements for services

Case manager plans for the services that the patient will need after discharge

Answer 3

Step 3—Review the progress of care

Question 4

Case manager performs final discharge planning

Patient’s continued care after discharge is determined with involvement of family members and the patient

Answer 4

Step 4—Conduct discharge planning

Question 5

Case manager conveys information about the patient’s course of treatment to the clinicians who will continue to care for the patient after discharge

Case management function is returned to the patient’s physician and office staff

Answer 5

Step 5—Conclude post-discharge planning