Professional Case Management最新文献

{"title":"Case Management in Prevention of 30-Day Readmission in Post-Coronary Artery Bypass Graft Surgery.","authors":"Annapoorna Mary, Fawaz Mzayek, Leanne L Lefler, Yu Joyce Jiang, Meghan Meadows Taylor","doi":"10.1097/NCM.0000000000000718","DOIUrl":"10.1097/NCM.0000000000000718","url":null,"abstract":"<p><strong>Purpose of study: </strong>Thirty-day readmission is associated with increased morbidity and mortality among postoperative coronary artery bypass graft (CABG) surgery patients. Interventions such as case management and follow-up care may reduce 30-day readmission. The purpose of this article is to report a study on modifiable factors that may have significant implications for case management in the prevention of readmission after CABG surgery.</p><p><strong>Primary practice settings: </strong>The study population included all the adult patients who underwent first-time CABG surgery from January 1, 2013, to January 1, 2016, from a Mid-South hospital.</p><p><strong>Methodology and sample: </strong>A retrospective case-control study was employed to examine 1,712 patients who underwent CABG surgery.</p><p><strong>Results: </strong>The results revealed that patients readmitted within 30 days had a significantly shorter length of stay (LOS) (6 days vs. 10 days; p < .0001), more days in intensive care unit (6 days vs. 4 days; p = .0391), and significantly higher diabetes/renal (4% vs. 1%), infection (17% vs. 2%), and respiratory-related diagnoses (10% vs. 1%; p < .0001).</p><p><strong>Implications for case management practice: </strong>Among these factors, hospital LOS is a major factor that can be addressed through case management in addition to other modifiable risk factors. Understanding modifiable factors associated with higher readmission risk is crucial for effective intervention and case management planning.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"21-27"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997785","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":"What Do Medicaid Members Want From Their Health Plan?: Insights From a Qualitative Study to Improve Engagement in Case Management.","authors":"Amy McQueen, David Von Nordheim, Tess Thompson, Kayla Manley, Albert J Pool, Matthew W Kreuter","doi":"10.1097/NCM.0000000000000716","DOIUrl":"10.1097/NCM.0000000000000716","url":null,"abstract":"<p><strong>Purpose of study: </strong>Managed care organizations (MCOs) provide case management services to address unmet health and social needs among their members. Few studies have examined factors influencing members' decision to participate in these programs. The purpose of the present study was to describe the life circumstances of Medicaid members offered case management, what they wanted from their MCO, and their perceptions of case management and barriers to participation. Results will inform practice to raise the awareness, engagement, and impact of case management programs.</p><p><strong>Primary practice settings: </strong>Case management offered through a Midwestern Medicaid MCO.</p><p><strong>Methodology and sample: </strong>Adult members who had been offered case management services in the 6 months preceding the study were eligible for the study. Fifteen people from each strata were recruited: members who engaged with case management, declined it, or declined it initially but later engaged ( N = 45). Participants completed a qualitative interview by phone and a brief health survey online.</p><p><strong>Results: </strong>Across strata, only 22 participants recalled engagement with case management. Members described a variety of life challenges (e.g., chronic health conditions, caregiver responsibilities, and limited finances) and services they desired from their MCO (e.g., stipends for over-the-counter health expenses, improved transportation services, and caregiver assistance). Participants identified direct communication, emotional support, and referrals for resources as benefits of case management.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"3-11"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997790","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":"I Wish the World Were More Like Case Managers.","authors":"Suzanne K Powell","doi":"10.1097/NCM.0000000000000771","DOIUrl":"10.1097/NCM.0000000000000771","url":null,"abstract":"<p><p>The CMSA Standards of Practice are a timeless compass for the treatment of others. Case managers know that when individuals reach an optimal level of functional capability, everyone benefits.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733349","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":"Leadership as a Calling for All Case Managers.","authors":"Kendra Greene, Vivian Campagna","doi":"10.1097/NCM.0000000000000770","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000770","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"33-34"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733350","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":"Gather \"Round\": An Integrated Care Model for the Emergency Department Multi-Visit Patient.","authors":"April Feld, Matt Carollo, Jere Freeman-Reyes, Susan McCarthy, Mary Ann Lind, Robert Weinstein, Caitlin O'Dea, Maria Joy, Eric J Morley, Paul Aitken, Robert Schwaner, Dominic Giarraputo, Samita M Heslin","doi":"10.1097/NCM.0000000000000756","DOIUrl":"10.1097/NCM.0000000000000756","url":null,"abstract":"<p><strong>Purpose: </strong>Emergency departments (EDs) are a vital component of the United States healthcare system and care for over 130 million patient visits annually. Nonurgent ED visits can contribute to crowding, delays in care, and adverse effects. Many high-utilizing ED patients may present with complex medical, behavioral, and social needs that are not necessarily emergent or urgent in nature. The authors created an Integrated Care Model, called the Multi-Visit Patient (MVP) program, for patients with 5 or more visits to the ED in a rolling 12-month period. The MVP program incorporated an interdisciplinary group of ED leadership and case management (CM) to identify, engage, and intervene with ED MVPs, aiming to improve their ED utilization. Patients received comprehensive screenings for depression, falls, alcohol use disorder, caregiver support, social determinants of health, and more. Based on these screenings, the CM team implemented interventions such as connecting patients with outpatient specialists and linking patients to community-based organizations to optimize stability, wellness, and reduce ED utilization.</p><p><strong>Primary practice setting: </strong>The collaboratively developed MVP program was implemented in the ED of a large, suburban, tertiary care academic hospital.</p><p><strong>Findings/conclusions: </strong>The MVP program identified 221 MVP patients over a 20-month period and successfully connected with 89% of them. Of these 221 patients, 78% (172 patients) chose to engage in the MVP program, with 160 completing their engagement with an outcome. Among the patients who completed their engagement and for whom the study could match separate utilization data (151 patients), the study observed a 57% reduction in ED visits.</p><p><strong>Implications for case management practice: </strong>Case managers play a crucial role in the effectiveness of the MVP program by coordinating comprehensive care for high-utilizing ED patients. The MVP program includes transition of care initiatives designed to improve patient outcomes. Through screenings and targeted interventions, case managers identify and address the complex medical, behavioral, and social needs of MVP patients. This collaborative, interdisciplinary approach underscores the importance of timely and coordinated care, benefiting both patients and the health system. The MVP program exemplifies the critical role of case managers in reducing unnecessary ED visits and enhancing overall patient care.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"12-20"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510029","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":"The Impact of an Online Preceptorship Training Program on Preceptor Self-Efficacy amongNurse Case Managers Working in an Acute Care Setting.","authors":"","doi":"10.1097/NCM.0000000000000768","DOIUrl":"10.1097/NCM.0000000000000768","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 6","pages":"E21-E22"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510033","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":"Multidisciplinary Meetings Build Community Partnerships, Increase Knowledge, and Support Helping Professionals.","authors":"Chelsea Arnold, Janice Houchins","doi":"10.1097/NCM.0000000000000762","DOIUrl":"10.1097/NCM.0000000000000762","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 6","pages":"276-279"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510032","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":"Addressing Physical and Mental Health: Work as a Transition of Care.","authors":"Ed Quick, Patricia Nunez","doi":"10.1097/NCM.0000000000000761","DOIUrl":"10.1097/NCM.0000000000000761","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 6","pages":"269-270"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510030","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":"Diversity, Equity, Inclusion, and Belonging's Evolving Regulatory Landscape: Legal Mandates and Ethical Context for Professional Case Management.","authors":"Ellen Fink-Samnick","doi":"10.1097/NCM.0000000000000765","DOIUrl":"10.1097/NCM.0000000000000765","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"29 6","pages":"271-275"},"PeriodicalIF":0.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510031","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":"How SWAT Changed the Conversation: Implementation of a Discharge SWAT Team Improves Morale and Facilitates Communication During the COVID-19 Pandemic.","authors":"Amanda Lenhard, Majd Daoud, Lisa Donahue, Sherri Jones, Paula L Kip, Rachel L Zapf, Tamra E Minnier","doi":"10.1097/NCM.0000000000000712","DOIUrl":"10.1097/NCM.0000000000000712","url":null,"abstract":"<p><strong>Purpose of study: </strong>Hospital overcrowding and delays in discharge are serious issues in the modern health care landscape and can lead to poor patient outcomes and health care personnel (HCP) burnout. The goal of this project was to develop a collaborative forum where HCP representing the entire spectrum of the inpatient care team, including case management team members, could connect to discuss challenges and barriers to patient discharge. The following describes the development, implementation, and outcomes of the discharge SWAT (Solutions, Wins, Actions, and Tactics) team, which is a 30-min virtual daily meeting where discussion is primarily centered around challenges in discharging individual patients and addressing case manager needs. The primary aim of SWAT meetings is fostering a positive atmosphere to address barriers to discharge while prioritizing patient care and outcomes.</p><p><strong>Primary practice setting: </strong>This study was conducted in a 40-hospital academic health system in the United States.</p><p><strong>Methodology and sample: </strong>SWAT meetings were first implemented at a representative flagship facility in a health system. HCP at this first facility were surveyed to assess satisfaction with SWAT meetings. SWAT meetings then were implemented at the majority of facilities in a 40-hospital academic health system. During SWAT implementation, average inpatient length of stay (LOS) and patient care transitions were monitored for participating and nonparticipating service lines.</p><p><strong>Results: </strong>Among surveyed HCP, the majority view SWAT meetings favorably and reported that it was a valuable use of their time and positively impacted their work in the patient discharge space. Nonprovider and case management staff in particular valued the SWAT meetings and found them beneficial. LOS remained stable for patients under the care of participating providers, despite the upheaval of the ongoing COVID-19 pandemic, and the research team also observed a positive impact of SWAT meetings on appropriate inpatient care transitions.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"254-262"},"PeriodicalIF":0.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997786","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}