Week 3 Notes .docx - Week 3 Notes Care and Case Management...

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Week 3 Notes Care and Case Management Care management —coordination of a plan or process to bring health services together as a common whole in a cost-effective way ** PROGRAM AS A WHOLE ** Case management —development and coordination of care for a selected client and family ** ONE PERSON** Case Management Roles Broker__________________________________________________________________ Consultant_______________________________________________________________ Coordinator______________________________________________________________ Educator________________________________________________________________ Facilitator________________________________________________________________ Liaison__________________________________________________________________ Mentor__________________________________________________________________ Monitor/reporter_________________________________________________________ Negotiator_______________________________________________________________ Client advocate___________________________________________________________ Researcher_______________________________________________________________ Standardization monitor____________________________________________________ Systems allocator_________________________________________________________ Evidence-Based Knowledge of Case Managers Home Care o Home care is part of a continuum of care where clients have the opportunity to live and move through the experiences of subacute, chronic, and end-of-life care. o The care given in home care settings is often managed and directed by a registered nurse . o Many aspects of the care in both generic and hospice home care are part of a larger care management plan that is individualized using a case management approach. o The care given in home care settings is interdisciplinary in nature. o Continuum of Care Case Management Model Case Management and the Nursing Process
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Week 3 Notes Assessment – collecting data Diagnosis – analysis of data to identify outcomes Outcome Identification – identification of nurse- sensitive measures Planning - nursing interventions towards outcomes Implementation - of plan in collaboration with clients and families Evaluation of the process Interdisciplinary Care Various members of the healthcare team, not just nurses, contribute their expertise to client management in the home. Home Visit Initiating the visit “CALL” Preparation Equipment Directions Personal safety**** The actual visit Assessing for risk of medication errors Assessing for risk of falls Assessing for risk of abuse and neglect Termination of the visit Post visit planning Caregivers Caregivers are often family members and friends . They must be considered members of the home care team and offered appropriate support if their commitment to care for a loved one at home is to be successful. Model of intensive case management (ICM) Kolbasovshy (2009) Reduced readmissions CARE ONE program: reduced emergency room (ER) visits 2012 Study: decreased acute outpatient and inpatient admissions Reduced readmissions Reduced ER visits Reduced acute outpatient and inpatient admissions Essential Skills for Case Managers Advocacy. o Aims to achieve patient engagement b y helping patients become invested in their health and care through programs that provide information and tools to empower them to take control and evaluate their care
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Week 3 Notes Process of advocacy o Promoting self-determination in clients o Informing : Amplifying Clarifying Verifying o Supporting o Affirming Illuminating values Conflict Management o Negotiation outcomes strategic process used to move conflicting parties toward an outcome. The outcome can
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