The Case Manager's Handbook / Edition 2

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Overview

Written by an active and nationally recognized case management consultant, The Case Manager's Handbook, Second Edition is the ultimate how—to guide —— designed to define good case management, examine the case management process and present practical procedural information. Virtually every chapter has been revised. New chapters and sections have been added to cover timely topics including ethics, legislation, disease management, managed care, credentialing groups, end—of—life issues, and do—not—recussitate orders, and much more. Packed with tried—and—true approaches to care and claims management, you'll find this book to be an excellent daily reference or a resource for a different approach. It can be used as a training guide for new case managers, or a teaching tool for client groups.

The book contains no figures.

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Editorial Reviews

Doody's Review Service
Reviewer: Lynn Riippi, RN, BSN, CCM (University of Colorado Health Sciences Center)
Description: This is a comprehensive look at the components involved in case management.
Purpose: The purpose is to provide a foundation of knowledge of those components.
Audience: It is written for all who are involved in case management or for those who need a general overview of the functions of a case manager.
Features: Before I began the book, I thought about the critical components I look for in reviewing the case management process. They include integration of clinical, financial, and data systems analysis, and the ability to work with a multidisciplinary team (including the patient). I found this book to be a very comprehensive look at all of these components. It also has a balance of theory and practical examples. As a case manager on the front line, I found Appendix 10-A (Program Questionnaire and Facility Review for Case Managers) and Appendix 5-B (Legal Issues in Case Management Checklist) tools I could incorporate into my day-to-day case management process. One area that most case management programs struggle with is how to calculate case management cost savings and case manager productivity. The author touched on these concepts in theory, but it would have been helpful to see more concrete examples.
Assessment: Overall, I feel this book can be used as a foundation for developing a case management program/process.
Eileen G. Hill
This new book is written to provide an integrated overview of the various roles, work formats, and processes a case manager encounters while coordinating the delivery of health care to patients. The purpose is to provide prospective and new case managers with more knowledge related to the case management profession, procedures, and future trends and opportunities. A second purpose is to increase communication and continuity of patient care between case managers, physicians, patients, families, and insurance parties. This book is written as a how-to guide for nurses, social workers, and rehabilitation specialists who may be training as case managers. The book is also written as a teaching tool for physicians and health care providers who are prescribing the care for patients a case manager oversees. This handbook is concise, easy to read, and informative. There are many examples of worksheets, summaries, contracts, and letters used by case managers to coordinate patient care services. The references are current, and the glossary offers useful medical, legal, and insurance terminology. This is an informative handbook for practitioners who desire to have a better understanding of case management in the health care delivery system. The book offers a look at the roles and responsibilities of a case manager as well as examples of practical issues to be used when coordinating patient care services. With guidelines to follow, the new case manager can receive assistance with problem solving so more time can be devoted to overseeing continuity of patient care.
Lynn Riippi
This is a comprehensive look at the components involved in case management. The purpose is to provide a foundation of knowledge of those components. It is written for all who are involved in case management or for those who need a general overview of the functions of a case manager. Before I began the book, I thought about the critical components I look for in reviewing the case management process. They include integration of clinical, financial, and data systems analysis, and the ability to work with a multidisciplinary team (including the patient). I found this book to be a very comprehensive look at all of these components. It also has a balance of theory and practical examples. As a case manager on the front line, I found Appendix 10-A (Program Questionnaire and Facility Review for Case Managers) and Appendix 5-B (Legal Issues in Case Management Checklist) tools I could incorporate into my day-to-day case management process. One area that most case management programs struggle with is how to calculate case management cost savings and case manager productivity. The author touched on these concepts in theory, but it would have been helpful to see more concrete examples. Overall, I feel this book can be used as a foundation for developing a case management program/process.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780834210738
  • Publisher: Aspen
  • Publication date: 4/1/1998
  • Series: Administration and Management Series
  • Edition description: Older Edition
  • Edition number: 2
  • Pages: 616
  • Product dimensions: 1.28 (w) x 6.00 (h) x 9.00 (d)

Table of Contents

Contributors
Preface
Pt. I Profile of a Case Manager 1
1 Nurse Case Manager Roles: Implications for Practice and Education 3
2 Redefining the Role of Clinical Nurse Specialists 15
3 Case Management as a Mindset 28
4 Components of a Successful Case Management Program 39
5 Managed Care, Utilization Management, and Case Management in the Emergency Department 47
6 The Johns Hopkins Hospital Launches Case Management Initiative 53
7 Case Management: Meeting the Needs of Chronically Ill Patients in an HMO 57
8 A Look at the Newest Ethical Issues in Workers' Compensation 70
Pt. II The Case Manager's Universe 73
1 A Case Study of Nursing Case Management in a Rural Hospital 75
2 Population-Based Case Management 82
3 Telephonic Nursing: Empowering Patients at Risk for Preterm Birth 95
4 In Case Management, Who's Watching the Store? Implementing Practice Parameters and Outcomes 103
5 A Framework for Integrated Quality Improvement 106
6 The Integration of Primary Care and Case Management in Chronic Disease 115
7 Managing and Redesigning the Continuum of Care: The Value Chain Model 121
8 Managing Critical Pathway Variances 128
9 Using Computer Systems To Enhance Case Management 142
Pt. III Case Management Administration and Financial Considerations 151
1 Activity-Based Costing for Hospitals 153
2 Monitoring Case Management Cost Savings 168
3 Pricing Specialty Carve-Outs and Disease Management Programs Under Managed Care 170
4 Case Management and Home Health Care: An Integrated Model 180
5 Tutorial: Causal Modeling and Patient Satisfaction 193
6 Comprehensive Case Management: Implications for Program Managers 203
7 Effects of the Program-Management Model: A Case Study on Professional Rehabilitation Nursing 213
8 The Change Process and a Clinical Evaluation Unit at University of Massachusetts Medical Center 219
Pt. IV Case Management in Action: Cases in Profile 231
1 Trauma Critical Pathways: A Care Delivery System That Works 233
2 Guidelines for Evaluation and Education of Adult Patients with Mild Traumatic Brain Injuries in an Acute Care Hospital Setting 237
3 The Challenges of Neurobehavioral Case Management 247
4 Returning Brain-Injured Clients to Work: A Team Approach 250
5 Approaching Health and Wellness Issues for Those with High-Level Spinal Cord Injury 254
6 The Effectiveness and Efficiency of an Early Intervention "Spinal Protocol" in Work-Related Low Back Injuries 258
7 HIV Continuum of Care: Challenges in Management 263
8 An Interdisciplinary Problem-Based Practicum in Case Management and Rural Border Health 274
9 Clinical Pathway Across Tertiary and Community Care After an Interventional Cardiology Procedure 284
10 Creating a Practice Partnership: A Clinical Application of Case Management 296
Index 309
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