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16 Cards in this Set
- Front
- Back
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Interdisciplinary Team Model
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Selected high risk cases are reviewed by a group
--Inpatient --Outpatient -Cases Identified by screening indictors -Group includes --Medical director --Social workers --Nurses --Other case managers |
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Case manager Staff Model
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-Provide services for ALL designated members of a system of care
-Case Managers carry caseloads -Predetermined identification and selection of high risk groups or populations -Approach useful for a specific diagnostic or specialty service area --Severe mental illness --Frail elderly programs --Transplant recipients --Patients with cancer --Patients who are developmentally disabled |
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Staff Case Managers Model
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-Employed by publically funded institutions/programs
-Backgrounds --Lay persons --professional HC workers |
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Consulting Group of Case managers model
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-selective case loads for special services
--coordinate refferals and interventoins --high cost services --prolonged treatment or illness -consult case managers work with several orgs. |
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How to ID Pt's who need case managemnet?
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-Screening, referal based, site ased, specialty defined(mental health), Problem defined (social problems)
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What is Level 1 supportive care?
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-gather data
-refer to HC ed. -arrange HC benefits -monitor complience -obtain durable med. eq. |
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What are level 2 Episodic Interventions?
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-arrange appropriate services
--wellness, prevention, ed, rehab -Social problems, support systems, financial management, environmental deficits, mental health, substance abuse, coping, complience, competency, adjustment disorders |
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What are level 3 chronic/at-risk case management? LTC
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-intense coord. for pt's at mod to high risk
-screening, assess -care planning, -implementing interventions -monitoring\ -reassessment -case conferences |
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What does specialty care management require?
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-interdisciplinary approach
-clinical services -hospice, transplant, HIV |
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What attributes make case management most effective?
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Team based model
-case managed across disciplines -few sites as possible |
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What are some essential skills of an effective Case manager?
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-Regular, careful communication
-Long-term collaboration with healthcare professionals -Willingness to draw on community and financial resources -Willingness to investigate alternative models of care for complex chronic illnesses -A willingness to “do what it takes” to keep patients stable and well. |
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Define Comorbidity?
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A medical condition that exists in addition to and is caused or worsened by obesity or any other primary disease being studied or treated
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Who are the substance abusers?
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-Patients with severe mental illness have markedly higher rates of abuse of substances, such as alcohol, tobacco, and illegal drugs, that the general population
-Social instability places these patients at risk for psychiatric and medical decompensation, recurrent hospitalization, incarceration, and homelessness |
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How does substance abuse effect a diabetic?
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Increased risk for Hypo and hyperglycemia.
-Psych meds effect CBG (Zeprexa, clozapine) -Wt gain is common, effects glucose control |
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What are some mental health complications of DM?
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-Vascular-related multi-infarct dementia
-Alzheimer-type dementia -Cognitive changes related to extremes of glucose control -Depression |
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What are the patient bill of rights?
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-emergency care
-Dx and prognosis info -unbiased care -voice grievances |
