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Case managers at Oxford Health Plans have a new set of tools to help noncompliant members in the plans diabetes disease management program.
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Coaching diabetics to make lifestyle changes, helping members overcome issues that affect their compliance, and offering classes to help patients cope with chronic disease have paid off for MVP Health Cares award-winning Diabetes Care program.
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More and more often, case managers are being called on to demonstrate their value by reporting on outcomes. But there are no hard-and-fast rules as to what outcomes to measure because they differ from organization to organization, says Mary Jane McKendry, RN, CCM, MBA, director of education, training, and consulting for McKesson Health Solutions.
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When it needed to hire nine nurse care managers for its in-house diabetes management program, Fallon Community Health Plan found a way to overcome the areas nursing shortage. It gave the nurse care managers in the diabetes program the opportunity to work flexible hours.
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A woman with diabetes who has struggled with compliance for years before getting her disease under control told Gayle McLaughlin, RN, BSN, Every time I start to go off track, I keep hearing your voice in my head.
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In order to meet todays challenges and those of the future, case managers need to stay connected and keep their finger on the pulse of todays health care system, says Anne Llewellyn, RN, BHSA, CCM, CRRN, CEAC.
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Prompting members who are at high risk for complications of diabetes to change their lifestyle to better control their disease is the hardest part of Fallon Community Health Plans diabetes program, points out Janice Betz, RN, senior clinical manager for diabetes care at Fallon.
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After four years of positive experiences with a national disease management vendor, Fallon Community Health Plan in Worcester, MA, decided it would be more beneficial to members and providers if the diabetes management program was transitioned in-house.
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Its not an urban legend or an Internet rumor. A Canadian woman really did walk through a metal detector at an airport and trigger the alarm, which led to the discovery that a 33 cm surgical retractor had been left in her abdomen after a procedure.
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The Joint Commission on Accreditation of Healthcare Organizations still requires you to mark the surgical site for some surgeries, but you wont have to mark all surgeries as originally required under National Patient Safety Goal No. 4.