Hospital Case Management
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Caring for Homeless Adults Through Case Management
As of 2020, more than half a million people were homeless in the United States. When a case manager cares for a patient who has no home or permanent place of residence, the plan can change quickly. While the general outline of the case management process might stay the same when serving a homeless individual, there are additional items to consider.
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Ethical Decision-Making for Case Managers
Every day, hospital case managers must make decisions — large and small — that affect the lives of their patients. Some of these are ethical decisions — what the case manager “ought” to do in a given situation. Since many decisions must be made quickly, hospital case managers should consider their ethics and plan ahead rather than reacting solely in the moment.
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Patient-Centered Care Can Improve Transitions
Patient-centered care is a simple, evidence-based way to improve care transitions and patient outcomes. Hospital case managers can benefit from learning more shared decision-making tactics.
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Target Low-Hanging Fruit in Preventing, Overturning Denials
The keys to preventing and overturning payer denials are to collect data to identify problem areas and to train staff in best practices. The case management team should understand the information each payer wants and how best to share those data.
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Understanding Medical Necessity Improves Utilization Review Process, Reduces Denials
The case management team should be trained thoroughly on utilization review and medical necessity to avoid payer denials. The goal is to ensure patients receive medically necessary, high-quality care. -
Study Suggests Perianesthesia Nursing Can Be Standardized Globally
A survey about education and the role of postanesthesia care unit nurses in 11 countries revealed a wide variation in how the profession was viewed and treated. There was little international standardization in education and professional guidelines.
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Ethical Responses Needed if Clinicians Say Discharge Is Unsafe
For some patients, there are no caregivers at home. Others may be living in unsafe conditions. Ethicists can help by brainstorming scenarios, and trying to connect resources accordingly.
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Start Small, Employ Relevant Personnel to Manage Complex Social Problems
Every hospital relies on a problem-solving method for performance improvement. The key is putting the right people on an intervention.
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Address Social Determinants of Health with Multidisciplinary Team, Community Partnerships
An ED Social Medicine team tackles social issues that often sabotage positive health outcomes and prompt repeat ED visits. The team includes clinicians, social workers, mental healthcare providers, patient navigators, a pharmacist, and transitional care personnel.
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Safety Protocol Can Prevent Self-Harm Incidents
Patients often present to the ED with behavioral health concerns, but psychiatric experts recognize the environment is hardly optimal for easing anxiety or calming a troubled mind. Further, patients with psychiatric concerns often wait in the ED for extended periods before they are connected with appropriate care, a time that can be fraught with danger for individuals at risk for self-harm. Recognizing the safety challenges at issue, a multidisciplinary team at Massachusetts General Hospital developed and implemented a protocol aimed at protecting such patients.