ABSTRACT
Emotional intelligence is a skill necessary for case managers because of the diversity of their work, the multiple stakeholders they have to deal with on daily basis, and the increased potential for conflict. Managers and administrators need to be cognizant of the role emotional intelligence plays in employee performance and the importance of developing training programs to assist case managers in learning to deal with change and conflict. Case managers must assume responsibility for their actions and work to develop and improve their emotional intelligence skills set. Ultimately, patients and work associates will appreciate the case manager's efforts. Finally, case managers will find work an enjoyable experience and look forward to new opportunities the future holds.
Subject(s)
Case Management , Emotions , Intelligence , Interprofessional Relations , Specialties, Nursing , Humans , Specialties, Nursing/education , Staff Development , United StatesABSTRACT
Fraudulent and abusive practices in home healthcare are costly. They damage the integrity of the home health agency, the home care industry, and home care providers. Federal and state enforcement activities have increased exponentially over the past few years to fight fraud and abuse, resulting in the collection of nearly $1.1 billion in fines, settlements, and administrative impositions in 1997. This article discusses the issues of fraud and abuse and the responsibilities of home healthcare providers toward prevention and control of such practices.
Subject(s)
Community Health Nursing/legislation & jurisprudence , Community Health Nursing/standards , Facility Regulation and Control/organization & administration , Fraud/legislation & jurisprudence , Fraud/prevention & control , Home Care Services/legislation & jurisprudence , Home Care Services/standards , Centers for Medicare and Medicaid Services, U.S. , Eligibility Determination , Health Services Accessibility/legislation & jurisprudence , Health Services Accessibility/standards , Humans , Quality Assurance, Health Care/organization & administration , United StatesABSTRACT
This article critically examines the definitions and component activities of case management in an effort to clarify and provide a better understanding of this phenomenon and to identify the areas that require further development for improving the knowledge base of this field. The approach is not meant to be exhaustive, but rather to offer a detailed analysis of the definitions of case management and delineate important issues relevant to case management practice.
Subject(s)
Case Management/organization & administration , Job Description , Terminology as Topic , Humans , Outcome and Process Assessment, Health Care/organization & administrationABSTRACT
The roots of case management are more than a century deep. This innovative approach to managing, coordinating, expediting, and facilitating patient care is neither new nor exclusively limited to nursing practice. A review of the historic literature reveals that the evolution of case management is a byproduct of creative healthcare efforts associated with different disciplines, including nursing, medicine, mental health, public health, and social work. This article presents a historical review of significant milestones in the evolution of the field of case management and its related tools (i.e., clinical pathways).
Subject(s)
Case Management/history , Case Management/legislation & jurisprudence , Critical Pathways/history , Health Personnel/education , Health Personnel/history , History, 19th Century , History, 20th Century , Humans , United StatesSubject(s)
Critical Pathways/organization & administration , Patient Care Team/organization & administration , Case Management/organization & administration , Cerebrovascular Disorders/nursing , Humans , Practice Guidelines as Topic , Professional Staff Committees/organization & administration , Program Development/methodsSubject(s)
Critical Pathways/organization & administration , Liver Transplantation/nursing , Patient Care Team/organization & administration , Postoperative Care/methods , Forms and Records Control , Humans , Liver Transplantation/adverse effects , Nursing Records , Outcome Assessment, Health Care , Patient Education as Topic , Program Development , Quality Indicators, Health CareSubject(s)
Case Management/organization & administration , Job Description , Nurse Administrators/organization & administration , Outcome and Process Assessment, Health Care/organization & administration , Humans , Nursing Assessment , Outcome and Process Assessment, Health Care/classification , Quality Indicators, Health CareABSTRACT
Interviewing for a job and conducting an interview are two challenging tasks nurse case managers experience at some point in their nursing career. One way to overcome such challenges is through learning more about the interview process. For the nurse case manager, the reward of interviewing well is getting hired for the job; for the interviewer, it is selecting the best candidate for the job. In this article, the author discusses the roles of the candidate and the interviewer in the interview process. It provides those interested in becoming nurse case managers with tips, skills, and strategies for assuring a successful interview. It also presents administrators of case management programs with beneficial recommendations for improving their interviewing skills. In addition, it discusses the interview process for potential candidates for nursing case management roles from the time of preparing the resume and cover letter until after the interview is completed.
Subject(s)
Case Management , Interviews as Topic , Job Application , Personnel Selection , HumansABSTRACT
The use of case management plans has contained cost and improved quality of care successfully. However, the process of developing these plans remains a great challenge for healthcare executives. In this article, the author presents the answer to this challenge by discussing a 10-step format process that administrators of patient care services and case managers can adapt to their institutions. It also can be used by interdisciplinary team members as a practical guide to develop a specific case management plan. This process is applicable to any care setting (acute, ambulatory, long term, and home care), diagnosis, or procedure. It is particularly important for those organizations that currently do not have a deliberate and systematic process to develop case management plans and are struggling with how to improve the efficiency and productivity of interdisciplinary teams charged with developing case management plans.
Subject(s)
Case Management/organization & administration , Critical Pathways/organization & administration , Diagnosis-Related Groups , Documentation , Forms and Records Control , Humans , Patient Care Team , Professional Staff Committees , Program DevelopmentABSTRACT
Case management plans have been used as a strategy for quality improvement and cost containment of healthcare. The authors discuss the methods used for evaluating the effectiveness of these plans. Variance analysis and measuring expected outcomes of care are the main themes. The authors also present one hospital approach to outcomes management that can be used by healthcare administrators to evaluate patient-care outcomes.
Subject(s)
Clinical Protocols/standards , Outcome and Process Assessment, Health Care , Patient Care Planning/standards , Evaluation Studies as Topic , Humans , United StatesABSTRACT
Case management plans are viable tools currently used to control healthcare cost and improve quality. The authors present a quality improvement-case management framework to guide nursing and hospital administrators in the development of these plans and to answer any questions they might raise while struggling through the process.
