Hospital Case Management
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Find out patients’ goals before introducing the idea of hospice
Take a patient-centered approach when you talk with patients and family members about end-of-life options and find out what they need and want before making suggestions.
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Get in touch with your own feelings before talking to patients
Case managers have to be comfortable with end-of-life issues before they can have a meaningful conversation with patients and families.
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Help patients and families as they struggle with end-of-life issues
More than 80% of patients say if they have a terminal illness, they don’t want to spend their last days in the hospital, according to the Dartmouth Atlas of Healthcare.
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Care coordination model works well with diabetes patients
An outpatient case management and care coordination program targeted a population of people with diabetes to improve quality of life and medical care.
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Patient’s last goal was to attend family reunion
A hospice and palliative care nurse practitioner recalls the case of a patient with a pressure ulcer that would not heal.
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Utilization review process calls for assessing patients at every point of entry
Dartmouth-Hitchcock Medical Center in Lebanon, NH, reviews every patient at every point of access to make sure that they are placed in the correct status.
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Hospitals push back against reimbursement cuts due to Two-Midnight rule
Hospitals across the country have filed lawsuits challenging the decision by CMS to reduce Medicare reimbursement by 0.2% to compensate for the financial effect of the Two-Midnight rule.
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Case management’s role in the new proposed bundled payment program
As we have discussed in prior editions of Case Management Insider, the 2010 Affordable Care Act was a game changer for the healthcare system. The payment reforms it introduced began the process of requiring health systems to communicate across the continuum of care and to reduce and/or eliminate existing silos. This across-the-continuum integration required sharing of accountability for cost and quality of care among providers.
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Ensure that services observation patients receive are necessary and timely
The move by CMS to change the payment methodology for patients receiving observation services means it’s more important than ever for case managers to ensure that patients receive the services they need in a timely manner and that they receive only the care they need while they are in an acute care setting, says Amy M. Smith, RN, MSN, CCM, director of case management at Dartmouth-Hitchcock Medical Center, a 421-bed academic medical center in Lebanon, NH.
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Ensure that patients meet criteria, documentation supports it
If you’ve got a system for getting patient status right up front and it works, don’t change anything but make sure that the documentation is detailed and complete, advises Linda Sallee, RN, MS, CMAC, ACM, IQCI, director for Huron Healthcare with headquarters in Chicago.