Eliminate sky-high wait times and increased denials in your ED Hospitals across the country are seeing extreme backup in the emergency department (ED). In recent years, well-structured emergency department case management programs have repeatedly demonstrated their value in: Influencing capacity Assigning patients to appropriate levels of care Targeting complex discharge needs Assisting with proper utilization review Whether you are looking to implement, maintain, or evolve your ED case management program, eliminate confusion surrounding the process with the help of Emergency Department Case Management: Strategies for Creating and Sustaining a Successful Program. Examining all perspectives of ED case management, this new and comprehensive guide will help you define a program that best suits your facility's needs. All the tools you need to get your program up and running From defining goals, clarifying roles, and understanding the necessary knowledge and skill sets required from ED case management staff, Emergency Department Case Management will help to ensure that you have a solid and sustainable foundation in place. After exploring models and reviewing your infrastructure, Emergency Department Case Management will help you outline key partnerships, present multiple options for case finding, tackle observation status, address quality and evaluation issues, and identify ways ED case managers can contribute to care coordination for complex pediatric, psychiatric, homeless, and uninsured populations. Written by Kathleen Walsh, RN, MS, and Karen Zander RN, MS, CMAC, FAAN, from the Center for Case Management, Emergency Department Case Management provides advice and best practices from two of the nations top case management experts. Take a look inside at the table of contents: Chapter 1: ED Case Management: The Heart of Access Chapter 2: The Foundation Chapter 3: Partnerships Chapter 4: The Process Chapter 5: Developing interventional strategies Chapter 6: Observation status determination Chapter 7: Program-level evaluation Chapter 8: Information system support Chapter 9: Quality Chapter 10: Addressing the pediatric population Chapter 11: Responding to the psychiatric population Chapter 12: Strengthening an existing program It's also packed with 15 detailed case studies discussing ED case management strategies, as well as five spotlight accounts detailing the experiences of ED professionals from across the country, including: A case manager A social worker A psychiatric nurse An information systems specialist An ED physician Don't hesitate to jumpstart your ED case management program. From beginning to end, Emergency Department Case Management will serve as the lead architect to help you design, build, and strengthen your ED case management model--order your copy today! Learning objectives: Conceptualize a framework for setting up an ED case management program Develop policies, procedures, and role descriptions Identify structural components, tools, and processes to support an ED case management program Describe potential outcomes of an ED case management program Who should buy this book? Emergency Department Case Management is the perfect resource for case managers, directors of case management, ED nurse managers, social workers, ED directors/administrators, and CFOs. HCPro Inc. has confirmed that none of the faculty presenters or contributors has any relevant financial relationships to disclose related to the content of this educational activity.The HCPro Risk-Free, Money-Back Guarantee If for any reason you're not completely satisfied with your purchase, return it within 30 days and you will receive a prompt, polite, 100% refund--no questions asked.

From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition will ensure that ED case management staff have a solid and sustainable foundation in place. After exploring models and reviewing emergency department infrastructure, this compendium will help readers outline key partnerships, present multiple options for case finding, tackle observation status accurately, address quality and evaluation issues, and identify ways ED RN case managers and social workers coordinate care for complex cases, such as pediatric, psychiatric, homeless, and uninsured populations. In addition to many new tools, this book is also packed with more than 20 detailed spotlights and case studies discussing ED case management strategies, best practices, and experiences of ED professionals from across the country. The new edition includes: The presence of case management RNs and Social Workers in emergency departments (ED) has become a standard since the first edition of this text was published in 2007. Ever-expanding and changing regulations for EDs and hospitals have emerged, while best practices have evolved to address these challenges. This new edition discusses these changes and provides updated guidance on running a compliant, effective, and efficient case management team in the ED. It also provides insight on adapting the role of case management based on unique ED patient populations and helps ED case managers stay ahead of the curve by examining what lies ahead in their profession.

Core Skills for Hospital Case Managers: A Training Toolkit for Effective Outcomes Toni Cesta, PhD, RN, FAAN; Beverly Cunningham, MS, RN As of June 20, 2014, contact hours for nurses are no longer available with this product. Finally--an affordable, effective, and consistent training program for your hospital case managers. This one-of-a-kind guide to fundamental case management responsibilities is a necessary reference tool for every hospital case management department. This resource is designed to give case management directors and hospital leaders the tools they need to build and strengthen the basic and advanced skills their case management staff needs to succeed. Core Skills for Hospital Case Managers is an orientation and training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to develop and maintain a wide variety of care management skills. Table of contents Chapter 1: Hospital Case Management 101 Chapter 2: Case Manager Role Chapter 3: Roles, Functions, and Caseloads Chapter 4: The Case Management Process Chapter 5: The Case Manager's Role in Transitional and Discharge Planning Chapter 6: Utilization Management Chapter 7: Managing Long Length of Stay Patients Chapter 8: Denials: Prevention and Appeals Strategies Chapter 9: Reimbursement Chapter 10: The Role of the Case Manager in Patient Flow Chapter 11: Measuring Success: Strategic Outcome Measures Chapter 12: Dealing with the Uninsured and Underinsured Chapter 13: Working with Multidisciplinary Teams Chapter 14: Crucial Communication and Conflict Resolution Learning objectives: Discuss the evolution of hospital case management Explain the different models of hospital case management Determine the various goals of hospital case management Examine the various roles of case management Discuss the variety of functions performed by case managers Discuss the scope of the case manager position Examine staffing ratios in various models List the steps in the case management process Determine the role of case managers in documentation Examine case managers' role in discharge planning List the factors that influence the discharge planning process Determine strategies for improving discharge planning Discuss how hospital reimbursement affects utilization management (UM) List the stages of UM coordination Determine the affect of outside influences on UM Evaluate different payers' regulations regarding UM Examine case management's role in length of stay (LOS) Evaluate strategies for managing patients with long LOS Identify data used to track and trend LOS Evaluate the reasons behind denials Discuss case management's role in preventing denials Examine case management's roles in reversing denials Examine case management's role in reimbursement Determine strategies for effective case management related to reimbursement Evaluate case management's role in patient flow Discuss demand and capacity management Identify strategies for managing patient flow Identify measurable case management outcomes Explain how case managers can track quality outcome metrics Discuss other metrics case management departments can track and trend Examine ways to create a case management report card Discuss the unfunded or underfunded patient populations Describe the role of the ED case manager with unfunded or underfunded patient populations Evaluate strategies for dealing with unfunded or underfunded patient populations Examine strategies for successfully working with multidisciplinary teams Describe sources of conflict with which case managers frequently come in contact Discuss strategies for reducing conflict Intended audience Staff nurses, charge nurses, staff educators, staff development specialists, directors of education, nurse managers, and nurse leaders

Across the country ambulances are turned away from emergency departments (EDs) and patients are waiting hours and sometimes days to be admitted to a hospital room. Hospitals are finding it hard to get specialist physicians to come to treat emergency patients. Our EDs demand a new way of thinking. They are not at a tipping point; they are at a break

"The hospital case manager is the person many turn to when answers are scarce. A case manager can persuade the patient and family/caregiver to become actively involved in the plan of care, and he or she can draw upon resources when nothing seems possible. The information the case manager communicates to the patient, the family/caregiver, the hospital team, and the postacute care providers is paramount to getting the patient the right care in the right place at the right time and potentially avoiding a readmission. Communication is essential to the role of case management, yet crafting a universal message that both the patient and the case manager understand is a challenge for many hospitals."--Back cover.

Written for a global audience, by an international team, the book provides practical, case-based emergency department leadership skills.

Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management