The Reason For A Case Management Approach

I will now talk about each patient needs as they all differ from each other. Nusrat Patel is 19 years old and has learning disability. This means Nusrat has difficulties in keeping knowledge and skills to the expected level of those the same age as her. Nusrat also has epilepsy which is neurological brain disorder when someone has epilepsy, it means they tend to have epileptic seizures, a seizure is a sudden attack of illness. Nusrat has left residential school to receive full time carer from her mum who has stopped working to care for Nusrat. At times this can be stressful so Nusrat attends the community centre on Tuesday and Thursday which allows Nusrat mother to have a break. Maria montanelli is 34 years primary school teacher who is much like Nusrat mother and takes care of her 96 years old mother who has dementia. Dementia is memory loss and difficulties with cognitive development. Being a primary care for her mother Maria feels she not performing at her best ability because of her lack of sleep which occurs when she assists her mother to the toilet several times. The last patient I would like to mention is Alice Fernandez she is 74 years old who recently lost her husband who had lung cancer. Alice doesn't use her pension the right way as she purchases many drinks as an alcoholic and has increased since her husband passed away. She has been prescribed antidepressant tablet by her G.P but made her lethargic this means she's become slow and sluggish.

There are always key elements to assessments and reviews, including the family and friends. Everyone has a responsibility to support individuals and bearing in mind ‘need to know’ information. The aim being able to achieve the highest goal to maintain effective open channels for everyone.

In order to, differentiate between utilization management and case management using the seven case management standards, it is first important to define each individual component. To begin with, a key component of quality and cost effective care is Utilization Management (UM). Utilization management is a way to assure that the appropriate care is medically efficient, a suitable use of health care services, proper procedures, and is applicable with provisions aligned in the health benefits plan. Case Management engages quality services in a timely coordination of patients’ specific needs in an approach that promotes positive outcomes by means that are cost effective. Case management may be developed during a single health care setting that may then transition throughout the care continuum. The seven standards are key components that described to maximize benefits and minimize the opposition.

Slade Plating Case Management Summary Despite the success of the Slade Company as manufacturer of metal products designed for industrial application, the production manager, Ralph Porter, was concerned about the dishonesty among employees in the Plating Department. Some of the workers were misusing the punch in-out system for those who wanted to leave early or arrive late. Given the long working hour and low payment, they lacked of motivation in performing their tasks, resulting in the dishonest action. However, because of informal groupings among some of them, they operated as a team to work harder doing peak orders. Therefore, the desired output of the department was still satisfied.

Within this case study I am going to use two of the Chapelhow et al. (2005) enablers to discuss and reflect on the care of a patient I have been involved with on placement over a period of 5 weeks. ‘Enablers are the essential and underpinning skills that come together to provide expert professional practice’ (Chapelhow, C et al. 2005, p.2). These include; assessment, communication, documentation, risk, professional decision making and managing uncertainty. The enablers work together to provide a holistic approach to the care of patients in health care settings. I am going to focus on and discuss two of the enablers, linking them both together, which will be assessment and communication as I believe these two enablers can be related most to my patient.

What I understand of case management is that it helps Social Workers in helping their clients, meaning social workers take actions to manage the various aspects of cases they are working on. Case management is also a shared process of assessment, planning, facilitation and advocacy for decisions and services to meet an individual’s need through communication and available resources. Case management examines the person’s physical, emotional, environmental state, and promotes quality and cost-effective outcomes. In addition, in Case management the worker helps to empower the clients to become self-sufficient. Moreover, Case management is structure into six principles

Lights of Zion will hire an experienced case manager/“reentry counselor,” to assist reentry experience from prison to sustained employment. The case management begins with a comprehensive individual assessment. From this assessment, a service plan is created that manages every aspect of the participant’s reentry program. The case manager monitors the plan, ensuring that all goals and objectives are being reached. Case manager Service will also participate in client recruitment, services, mentorship and job training and placement.

I: CM used active listening and asked open ended questions to continue building a rapport with client. CM inquired about the client’s SSDI check status. CM inquired about the client’s health. CM informed client of CES housing option along with his status in the LAMP VASH program. CM encouraged the client to participate in the next PTSD support group meeting. CM assessed client's mental health, substance abuse, and medication compliance.

Case management as a health care strategy, has experienced increasing attention since it was implemented with managed care in the 1980s and 1990s to control the rising costs of health care (Dunham-Taylor, 2015). When case management is utilized, efforts are initiated to identify and assist high risk, high cost Medicare and Medicaid enrollees and persons with complex conditions, for the transition from hospital to home to provide care in a less expensive setting and avoid unnecessary medical costs (Dunham -Taylor, et al., 2015). As an example, chronic illness such as diabetes mellitus “places a significant burden on the U.S. health care system” (Rubin, et al., 1998). Research has shown that patients with diabetes being treated through various

Within OU Case Management there are several parts of Hierarchy. Top-level management would be the Dean of Nursing whom is a doctor, who is over the whole department of Nursing and Case Management. Then there is the Director of Case Management whom is an RN, who reports to the Dean of Nursing. The director has two supervisors that are under her. There is the Supervisor over the Case managers that is an RN and then there is the supervisor over the administrative and billing staff. The supervisors also report information to the Department of Human Services (DHS) because we have members that use Medicaid which is a state funded medical insurance for people whom cannot afford to pay for medical insurance on his or her own. We also have a marketing

There seems to be many different titles for the same positions. I am definitely starting to get confused. You mentioned your facility using Patient Care Managers, is this similar to Patient Care Coordinator, Case Managers or CNLs? I think a Patient Care Manager would be an uncertified version of a CNL from what I could find on the All Nurses website (All Nurses, 2011). I can see your point in the long term sustainability of the position. The title and role of Clinical Nurse Leader has been around since 2007 (University of San Francisco, 2011). It has been reported that CNL add value in their role through and longer term job sustainability through their focus on safety and quality of service to save their facilities

I work as a case manager as well. My former work as an RN case manager is in a medical group and my current setting is also in a medical group but I am now assigned in one of the hospitals, here in Southbay California. Great post regarding the transition of care. You are also correct, that CHF is one of the leading cause of patient re hospitalization, which is followed by Pneumonia and MI. Unfortunately, high readmission rate is a current issue that needs to be addressed, and that is also why Medicare will reduce payment to hospitals with excess readmission rates. (Kripalani S., Theobald, C., Anctil, B., & Vasilevskis, E. 2014). Although, this is a great effort, we can still see patients going back to the hospital within the 30 days. Studies

Case Management generally refers to the ongoing coordination of needed services via a designated professional or team. In the past decade, Case Management (CM) earned a variety of meanings and various models of CM have emerged. Considering systems reform and managed care, CM is a position in transition. Within that transition, the overlap of service coordination, case management, and care management functions has begun to play a critical role in the workforce and the community at large. However, in practice, each position reflects different principles or activities as an important component of service delivery to achieve quality, efficiency, and efficacy goals.

Finally, as it relates to case management needs, in this first stage of the engagement, the author considers that it is necessary to cooperate with the social service. The social worker deals with the issue of residence, family, health care, checks for legal issues. Additionally, information is provided for client’s diagnosis and the types of treatment programs (residential treatment, hospitalization, non residential program, outpatient settings e.t.c) that have in the organization; their philosophy, their limits and their daily program. Nevertheless, the effectiveness of case management approach may vary (Graham, & Timney, 1990). Surely, study confirms that case management needs functions positively to people with drug

Case was referral for case manager because pt’s mom is separating from his father. She is not documented and is considering returning to the Dominican Republic, unsure how to navigate the documentation process. Case manager spoke with pt’s mom as per mom her husband decided to help her with the documentation. Pt’s mom state that she is having problem at the school, because pt’s brother was placed in a different bus. Case manage and clinician Dr. Pendleton assist mom with issue . Case is close with case management