Professional Case Management最新文献

{"title":"Increasing Follow-Up Appointment Completion Rates in Transitions of Care.","authors":"Kimberly D Reschke","doi":"10.1097/NCM.0000000000000755","DOIUrl":"10.1097/NCM.0000000000000755","url":null,"abstract":"<p><strong>Purpose of study: </strong>Noncompletion of follow-up appointment requests is an ongoing problem due to competing staff responsibilities, technology challenges, and inadequate communication during hospital transitions to post-acute care. From 1 January 2019 to 31 March 2019, 58% of follow-up appointments requested by an acute care hospital on discharge were not ordered after transition of care to a skilled nursing facility (SNF) and 44% of SNF residents were readmitted to acute care within 30 days. The follow-up appointment completion rate was 42%. Barriers associated with poor attendance of follow-up appointments were not documented. The purpose of the study is to implement a follow-up appointment completion protocol to increase follow-up appointment completion rates and identify barriers to decrease hospital readmission rates with the use of a computerized clinical information system.</p><p><strong>Primary practice setting: </strong>A 232-bed for-profit, corporate-owned SNF in the west suburb of Chicago that offers a variety of services in addition to skilled nursing care including short-term rehabilitation, physical therapy, and long-term care.</p><p><strong>Methodology and sample: </strong>An attendance log was utilized to evaluate stakeholder agreement and completion of staff training. Data were collected electronically via a password-protected Microsoft Excel spreadsheet by the project director to evaluate the completion of orders placed for follow-up appointments and chart audits were completed. A quantitative data analysis was completed to obtain the percentage of the number of key stakeholders in agreement of interventions, staff attendance to training sessions, and residents whose orders for follow-up appointments were entered into PointClickCare (PCC). To evaluate the barriers identified, completion of follow-up appointments, hospital readmission rates, and chart audits were completed throughout the project implementation and data were collected electronically via a password-protected Microsoft Excel spreadsheet by the project director. Post implementation data were collected biweekly for 1 month, and then again for 1, 2, and 3 months throughout the project implementation. A quantitative data analysis was completed to obtain the percentage of barriers identified, completion of follow-up appointments, and hospital readmission rates.</p><p><strong>Results: </strong>81% of admitted residents to the short-term care stay unit had orders for follow-up appointments. The follow-up appointment completion rate increased to 46% and the readmission rate decreased by 20%. Barriers were identified as non-scheduled appointments and resident refusal.</p><p><strong>Implications for case management practice: </strong>Implementing a follow-up appointment protocol can significantly enhance the quality of patient care and operational efficiency. Regular follow-up appointments allow health care professionals to assess progress, manage medications","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Sides of the Legal Coin: The Right to Health and the Right to Autonomy in the Case of Vaccinations.","authors":"Yael Keshet, Ariela Popper-Giveon, Tamar Adar","doi":"10.1097/NCM.0000000000000739","DOIUrl":"10.1097/NCM.0000000000000739","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 4","pages":"178-182"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMSA Annual Conference Is the Premier Case Management Event of the Year.","authors":"Janet Coulter","doi":"10.1097/NCM.0000000000000737","DOIUrl":"10.1097/NCM.0000000000000737","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 4","pages":"171-172"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Mental Health Services for Frequent Emergency Department Users: A Qualitative Study of Outcomes Perceived by Program Clients and Case Managers.","authors":"Jonathan Samosh, Ayda Agha, Donna Pettey, John Sylvestre, Tim Aubry","doi":"10.1097/NCM.0000000000000692","DOIUrl":"10.1097/NCM.0000000000000692","url":null,"abstract":"<p><strong>Purpose of study: </strong>This study aimed to investigate the perceived outcomes and mechanisms of change of a community mental health service combining system navigation and intensive case management supports for frequent emergency department users presenting with mental illness or addiction.</p><p><strong>Primary practice setting: </strong>The study setting was a community mental health agency receiving automated referrals directly from hospitals in a midsize Canadian city for all individuals attending an emergency department two or more times within 30 days for mental illness or addiction.</p><p><strong>Methodology and sample: </strong>Qualitative interviews with 15 program clients. Focus groups with six program case managers. Data were analyzed using pragmatic qualitative thematic analysis.</p><p><strong>Results: </strong>Participants generally reported perceiving that the program contributed to reduced emergency department use, reduced mental illness symptom severity, and improved quality of life. Perceived outcomes were more mixed for outcomes related to addiction. Reported mechanisms of change emphasized the importance of positive working relationships between program clients and case managers, as well as focused efforts to develop practical skills.</p><p><strong>Implications for case management practice: </strong>Community mental health services including intensive case management for frequent emergency department users presenting with mental illness or addiction were perceived to effectively address client needs while reducing emergency department resource burden. Similar programs should emphasize the development of consistent and warm working relationships between program clients and case managers, as well as practical skills development to support client health and well-being.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"139-148"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Management Approach in Stroke Care: A Mixed-Methods Acceptance Analysis From the Perspective of the Medical Profession.","authors":"Juliane Andrea Duevel, Alina Baumgartner, John Grosser, Simone Kreimeier, Svenja Elkenkamp, Wolfgang Greiner","doi":"10.1097/NCM.0000000000000701","DOIUrl":"10.1097/NCM.0000000000000701","url":null,"abstract":"<p><strong>Purpose of study: </strong>In terms of continuous and coordinated health care, cross-sectoral care structures are crucial. However, the German health care system is characterized by fragmentation of medical services and responsibilities. This fragmentation leads to multiple interfaces frequently causing loss of information, effectiveness, and quality. The concept of case management has the potential to improve cooperation between sectors and health care providers. Hence, a case management intervention for patients with stroke was evaluated with an acceptance analysis on the physicians' willingness to cooperate with stroke managers and their assessment of the potential of case management for the health care of patients with stroke.</p><p><strong>Primary practice settings: </strong>Primary practice settings included physicians working in the hospital, rehabilitation, and outpatient sectors who had actual or potential contact with a stroke case manager within the project region of East Westphalia-Lippe.</p><p><strong>Methodology and sample: </strong>The analysis was conducted using a mixed-methods approach. Expert interviews were conducted in 2020. Afterward a questionnaire was developed, which was then distributed to physicians in 2021. Both the interviews and the questionnaire included questions on conceptual knowledge and concrete expectations prior of the project, on experiences during the project and on recommendations and physicians' assessment of future organization in health care to classify and describe the acceptance.</p><p><strong>Results: </strong>Nine interviews were conducted and 23 questionnaires were completed. Only slightly more than 50% of the physicians had prior knowledge of the case management approach. Overall, ambiguous results concerning the acceptance of case managers were revealed. Additional personal assistance for patients with stroke was seen as beneficial at the same time critical perspectives regarding further fragmentation of health care and overlapping of competences with existing professional groups or forms of health care were collected. General practitioners in particular were critical of the case management approach.</p><p><strong>Implications for case management practice: </strong>From the physicians' point of view, at least two changes are necessary for the project approach to be integrated into standard care. First, the target group should be adapted according to the case management approach. Second, the delegation of tasks and responsibilities to case managers should be revised. The sectoral difference in the acceptance of case managers by physicians indicates that active cooperation and communication in everyday work has direct impact on the acceptance of a new occupational profession. Physician acceptance has a significant impact on the implementation of new treatment modalities and thus influences the overall quality of health care.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"158-170"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing Delirium to Light: Impact of CAM-ICU Tool to Improve Care Coordination.","authors":"Theresa Savino, Franz H Vergara, Mary Dioise Ramos, Deborah Warzecha","doi":"10.1097/NCM.0000000000000715","DOIUrl":"10.1097/NCM.0000000000000715","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a serious complication in patients in the critical care unit (CCU) that may lead to prolonged hospitalization if left undetected. The CCU at our hospital does not have a framework for determining delirium that could affect patient outcomes and discharge planning.</p><p><strong>Primary practice setting: </strong>CCU in a community hospital.</p><p><strong>Method: </strong>A posttest-only design was used for this study. We established a framework for the early assessment of delirium, educated and trained nurses to detect delirium, collaborated with the informatics department, intensivist, nursing, respiratory therapy and worked with case management to deploy the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). We used a one-tailed independent t test to determine the impact of CAM-ICU on length of stay (LOS). Cross-tabulation and chi-square tests were used to examine the impact of CAM-ICU tool on home care utilization between the intervention and comparison groups.</p><p><strong>Results: </strong>There was a 3.12% reduction in LOS after implementing the CAM-ICU tool. Also, a reduction in home care service utilization demonstrated statistical significance ( p = .001) between the intervention group (62.5%; n = 177) and the comparison group (37.5%; n = 106).</p><p><strong>Implications for case management practice: </strong>Case managers are essential in improving care transitions. Case managers need to become competent in understanding the implications of the CAM-ICU tool because of their relevant role in the multidisciplinary rounds as advocates to improve care transitions across the continuum of care. Case managers need to have an understanding on how to escalate when changes in the Richmond Agitation-Sedation Scale scores occur during the multidisciplinary rounds because it can affect care coordination throughout the hospital.</p><p><strong>Conclusions: </strong>Implementing the CAM-ICU decreased LOS, and reduced health care utilization. The early identification of patients with delirium can affect the outcomes of critically ill patients and entails multidisciplinary collaboration.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"149-157"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Based Differences in the Practices and Perceptions of Psychiatry Residents Working in Closed Wards as Case Managers.","authors":"Amit Yaniv-Rosenfeld, Amir Elalouf, Hagai Maoz","doi":"10.1097/NCM.0000000000000741","DOIUrl":"10.1097/NCM.0000000000000741","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 4","pages":"183-186"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving From a Good to Great Case Manager.","authors":"Elaine Bruner","doi":"10.1097/NCM.0000000000000738","DOIUrl":"10.1097/NCM.0000000000000738","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 4","pages":"173-174"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Hospital Healthcare at Home-How Is It Going?","authors":"Suzanne K Powell","doi":"10.1097/NCM.0000000000000736","DOIUrl":"10.1097/NCM.0000000000000736","url":null,"abstract":"<p><p>The Centers for Medicare & Medicaid Services' (CMS) Acute Hospital Care at Home (AHCAH) waiver, which launched in November 2020, has prompted hundreds of hospitals across the country to initiate programs that allow certain patients to complete their acute care stays in the familiar comfort of their homes. But this waiver is about to expire in December 2024. It is a success; but can we continue it?</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 4","pages":"137-138"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and Deploying Emotional Intelligence to Uncover and Address Clients' Needs.","authors":"Vivian Campagna, Ellen Mitchell","doi":"10.1097/NCM.0000000000000740","DOIUrl":"10.1097/NCM.0000000000000740","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 4","pages":"175-177"},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}