In today’s healthcare, case management ascends to an irreplaceable component in delivering quality care. The interaction of the case managers with multiple departments in a health system allows open communication, resulting in quality metrics demonstrating value in areas such as length of stay, observations, accounts receivable, and appeals or denials of patient care (Miodonski 2011). According to the Case Management Society of America (CMSA) hospital case management exists as a collaboration of assessments, plans, implementations, coordination, monitoring and evaluations of options and services for healthcare consumers.
Huntsville Hospital (HH) Case Management strives to provide efficient and appropriate health care services in the least …show more content…
HH Case Managers assist HH in attaining success with the Triple Aim: improving the patient care experience, improving the health of consumers, and reducing costs. Following the Standards of Practice for Case Management, case managers use evidence-based guidelines and employ best practice involving the patient and the caregivers. For example, a patient experiences a traumatic injury from a car accident, the case manager meets with the patient and caregiver on the second day of admission, explores and evaluates the needs, community resources, medications, and potential discharge disposition. During the acute care phase the case manager assists the family to find a location close in proximity to the hospital, while also collaborating with the physician on medications and treatments. Finally, if post acute placement is necessary the case manager assisting the patient and family in securing an appropriate rehabilitation in relation to insurance, location, and provision of care. Huntsville Hospital Case Management experienced multiple variations of case management models throughout the years. Initially, in the 1980’s, the bedside nurse performed as the case manager, evolving in the 1990’s to the functional model providing discharge …show more content…
The continued quality improvement programs incorporated in HH continue to prove the appropriate care deleting unnecessary treatments. In turn, maximizing the patient’s healthcare benefits or value results in cost savings and higher quality care (Porter & Lee 2013). According to HH’s Brenda Brooks, “we (case management/quality assurance) have merged supply driven, fragmented care into a patient outcome delivery system, assisting the consumer in maximizing benefits with high value care. An example of a chronic back pain, expensive and disabling ailment, patient provides an excellent example of previously fragmented care receiving portions of care from various clinicians and locations resulting in unneccesary or duplicate treatments, such as x-rays or medications. A case manager’s concentration on this specific patient originally seen in the acute care setting provides efficiency in treatments with physical therapy, other ancillary departments, pain clinic, and physicians, ultimately providing a pathway to measuring patient
Huntsville Hospital (HH) Case Management strives to provide efficient and appropriate health care services in the least …show more content…
HH Case Managers assist HH in attaining success with the Triple Aim: improving the patient care experience, improving the health of consumers, and reducing costs. Following the Standards of Practice for Case Management, case managers use evidence-based guidelines and employ best practice involving the patient and the caregivers. For example, a patient experiences a traumatic injury from a car accident, the case manager meets with the patient and caregiver on the second day of admission, explores and evaluates the needs, community resources, medications, and potential discharge disposition. During the acute care phase the case manager assists the family to find a location close in proximity to the hospital, while also collaborating with the physician on medications and treatments. Finally, if post acute placement is necessary the case manager assisting the patient and family in securing an appropriate rehabilitation in relation to insurance, location, and provision of care. Huntsville Hospital Case Management experienced multiple variations of case management models throughout the years. Initially, in the 1980’s, the bedside nurse performed as the case manager, evolving in the 1990’s to the functional model providing discharge …show more content…
The continued quality improvement programs incorporated in HH continue to prove the appropriate care deleting unnecessary treatments. In turn, maximizing the patient’s healthcare benefits or value results in cost savings and higher quality care (Porter & Lee 2013). According to HH’s Brenda Brooks, “we (case management/quality assurance) have merged supply driven, fragmented care into a patient outcome delivery system, assisting the consumer in maximizing benefits with high value care. An example of a chronic back pain, expensive and disabling ailment, patient provides an excellent example of previously fragmented care receiving portions of care from various clinicians and locations resulting in unneccesary or duplicate treatments, such as x-rays or medications. A case manager’s concentration on this specific patient originally seen in the acute care setting provides efficiency in treatments with physical therapy, other ancillary departments, pain clinic, and physicians, ultimately providing a pathway to measuring patient