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cover image - Nursing Case Management,4th Edition
ISBN: 9780323027656
Page Count: 640
Imprint: Mosby
List Price: $76.95

Nursing Case Management, 4th Edition

by Elaine Cohen, EdD, RN, FAAN and Toni G. Cesta, PhD, RN, FAAN


cover image - Nursing Case Management,4th Edition
ISBN: 9780323027656
Page Count: 640
Imprint: Mosby
List Price: $76.95
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This classic resource offers complete coverage of nursing case management — from theoretical background and historical perspective to practical applications and how the field is changing to meet the challenges of today's health care environment. It focuses on the implementation of various case management models used throughout the United States and abroad. Key topics include the impact of public policy on health care; understanding the effects of health care reimbursement and its application at the patient level; throughput and capacity management; the impact of the revenue cycle; compliance and regulatory issues; and principles needed to improve case manager-client interaction. This helpful resource is designed to help nurse case managers assess their organization's readiness for case management, prepare and implement a plan to achieve necessary improvements and evaluate the plan's success.
    • Includes numerous proven case management models currently being used in institutions across the country
    • Organized to take the nursing case manager on a journey from the historical development of nursing case management to the successful implementation of a case management program
    • Offers detailed guidance for planning, implementing, and evaluating a case management program
    • Outlines the planning process with information on key topics such as analysis of the organization, the role of the organization's members, selection criteria for new case managers, case management education, credentialing, and partnerships
    • Features guidelines for implementing a case management program with information on ethical issues, technology, compliance, and regulatory issues
    • Addresses the evaluation component of developing and implementing a case management program by presenting information on outcomes, research, documentation, continuous quality improvement, measuring cost effectiveness, care continuum, and evidence-based practice
    • Presents acute care and community based models of case management
    • Highlights the evolution of collaborative models of case management, addressing key elements of joint decision-making, shared accountability, and interdisciplinary systems of care
    • Addresses health care delivery through case management and public policy by presenting current legislative issues and their affect on both health care reimbursement and the application of care at the patient level
    • Presents the insights, experiences, and advice of nursing administrators who have researched and successfully implemented nursing case management programs in various facilities
    • A new chapter, Telehealth Applications for Case Management, introduces the concept of telehealth; provides examples of telehealth usage in women's health, chronic disease management, and mental health; and summarizes the evidence that supports telehealth and identifies existing issues and challenges.
    • Case Management: Life at the Intersection of Margin and Mission, is a new chapter that highlights strategies case managers and others can use to optimize their organizations' financial outcomes while simultaneously improving clinical outcomes for their patients. It emphasizes the work of case managers in the financial arena of health care, including revenue cycle management.
    • A new chapter, Maximizing Reimbursement through Accurate Documentation and Coding, provides tips and strategies on maximizing reimbursement by designing and implementing programs focused on improving the physician's documentation.
    • Effective Management Tools for Case Management Leaders: Strategy Maps and Balanced Scorecards, A Case Study is a new chapter that discusses strategy maps and balanced scorecards and their role in transforming an organization's mission and strategy into a management system and a comprehensive set of performance measures.
    • Features updated information on HIPPA regulation (Health Insurance Portability and Accountability Act), patient safety and confidentiality issues, case management for Medicare patients, Medicare legislation, and utilization management.

    1. Evolution of Nursing Case Management in a Changing Health Care System
    2. Historical Perspective of Nursing Care Delivery Models within the Hospital Setting
    3. Historical Development of Case Management


    4. Dimensions of Nursing Case Management
    5. Two Strategies for Managing Care: Care Management and Case Management
    6. Disease Management: Applying Systems Thinking to Quality Patient Care Delivery


    7. Within-the-Walls Case Management: An Acute Care-Based Nursing Case Management Model
    8. Collaborative Models of Case Management
    9. Case Management: A Process Not a Person
    10. The University of Colorado Hospital Psychiatric Service Health Case Management Model: An Innovative Approach to Client-Centered Care


    11. Beyond-the-Walls Case Management
    12. Outcomes of Community-Based Nurse Case Management Programs
    13. Integrated Case Management Model
    14. A Faculty Case Management Practice Based in a College of Nursing
    15. A Model of Emergency Department Case Management: Developing Strategies and Outcomes


    16. Patient Demographic Affecting Health Care
    17. The Business of Health Care and the Prospective Payment System
    18. Patient Mix and Cost Related to Length of Hospital Stay
    19. Case Management Legislation: National Attempts to Provide Efficient Health Care
    20. The Managed Care Market: Nurse Case Management as a Strategy for Success
    21. Financing Health Care in the U.S.: Economic and Policy Implications
    22. Public Policy, and Community-Based Case Management: The Nurse-Family Partnership


    23. Assessing the System and Creating an Environment for Change
    24. Case Management Education: Preparing for Successful Implementation
    25. The Competency Outcomes and Performance Assessment Model Applied to Nursing Case Management Systems
    26. The Role of the Nurse Case Manager
    27. Credentialing for Case Management: Licensure, Certification, Certificate Programs, and Accreditation
    28. Facilitating Educational and Career Mobility: Online Case Management


    29. The Cast of Characters
    30. Variations Within Clinical Settings
    31. Brainstorming: Development of the Multidisciplinary Action Plan (MAP)
    32. Interdisciplinary Care Planning and Documentation using NIC and NOC
    33. Ethical Issues in Case Management
    34. Case Management and Information Technology
    35. NEW! Telehealth Applications for Case Management
    36. Compliance and Regulation


    37. Key Functions and Direct Outcomes of Case Management
    38. NEW! Case Management: Life at the Intersection of Margin and Mission
    39. NEW! Maximizing Reimbursement through Accurate Documentation and Coding
    40. The Data-Driven Health Care Environment: Methods of Gathering and Presenting Relevant Data About Health Care Systems
    41. The Importance of Research in the Evaluation Process
    42. Documentation of Quality Care
    43. The Link Between Continuous Quality Improvement and Case Management
    44. Job Satisfaction
    45. Nurse Case Manager Job Characteristics and Effects on Well-Being
    46. Measuring Cost-Effectiveness
    47. Case Management Evaluation: The Use of the Cost-Effectiveness Analysis Method
    48. Linking the Restructuring of Nursing Care With Outcomes: Conceptualizing the Effects of Nursing Case Management using Measurement and Logic Models
    49. An Overview of Assessing Health Through Quality of Life Indicators
    50. NEW! Effective Management Tools for Case Management Leaders: Strategy Maps and Balanced Scorecards, A Case Study
    51. Outcomes Effectiveness and Evidence-Based Practice
    52. The Carondelet Community-Based Nurse Case Management Program: Yesterday, Today & Tomorrow
  • Elaine Cohen, EdD, RN, FAAN, Director of Case Management, University of Colorado Hospital, University of Colorado Health Sciences Center, Denver, CO and Toni G. Cesta, PhD, RN, FAAN, Director of Case Management, Saint Vincent Catholic Medical Centers of New York, Manhattan Region; Principal, Case Manager Solutions, LLC, Tucson, AZ
Was $76.95

Now $57.71

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Important note
Please note
This item has low stock levels and may be back-ordered. We'll let you know if it is back-ordered, and you will not be charged until the item ships.