Introduction to Care Coordination and Nursing Management

, by Fero, Laura J.; Herrick, Charlotte; Hu, Jie

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ISBN: 9780763771607 | 0763771600
Cover: Paperback
Copyright: 8/3/2010

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Introduction to Care Coordination and Nursing Managementis an introduction and overview of nursing case management across the health care continuum. It covers topics that address health care management in the hospital as well the community, such as Congregational Nursing and introduces the student to being a potential private practitioner touching on entrepreneurship, consultation and marketing.Each chapter includes discussion questions and short assignments to help students learn.

Preface	p. xi
Acknowledgments	p. xiii
Contributors	p. xv
Introduction to Nursing Case Management	p. 1
Definitions of Case Management	p. 1
Case Management: Its Process and Characteristics	p. 2
Case Management Organizations: An Alphabet Soup	p. 6
Managed Care	p. 6
Case Management as a Process	p. 10
Historical Perspectives and Current Trends	p. 10
Maintaining Quality	p. 19
Appendix to Chapter 1 Nursing Case Management	p. 29
Definitions	p. 29
Alphabet Soup of Managed Care	p. 40
Cultural Competence	p. 43
Introduction	p. 43
Definitions	p. 44
Cultural Competence Overview	p. 49
Models of Cultural Competence	p. 49
Cultural Competence and Communication	p. 53
Cultural Issues Related to Health Care	p. 55
Managed Care: Examining Today's Healthcare System	p. 67
Introduction	p. 67
The U.S. Healthcare System	p. 68
Healthcare Reform	p. 69
The Development of Managed Care	p. 70
What Is Managed Care?	p. 72
Managed Care Plans	p. 74
Managed Care and Cost Savings	p. 76
Managed Care and Quality	p. 76
Nurse Case Management in a Changing Healthcare System	p. 80
Case Management: An Overview of Roles, Skills, and Functions	p. 89
Introduction	p. 89
Communicator	p. 90
Broker	p. 94
Negotiator	p. 94
Advocate	p. 97
Educator	p. 100
Change Agent	p. 101
Coordinator and Care Facilitator	p. 102
Discharge Planner	p. 103
Resource Manager, Utilization Manager and Reviewer, Gatekeeper, Payer-Based Nurse Case Manager, and Financial Advisor	p. 104
Administrator/Manager/Leader	p. 109
Researcher	p. 110
Clinician	p. 112
Models of Care	p. 119
Introduction	p. 119
"Within the Walls" Models: Acute Care	p. 120
"Beyond the Walls" Models: Community-Based Care	p. 125
Continuum-of-Care Models: Within the Walls and Beyond	p. 131
Nursing Case Management: Building Collaborative Relationships with Patients	p. 145
Introduction	p. 145
Collaboration: An Essential Ingredient	p. 146
Building an Interdisciplinary Team	p. 148
The Social Work-Nurse Dyad: A Collaborative Case Management Team	p. 155
The Case Manager in Private Practice	p. 169
Introduction	p. 169
Definitions: What Is an Entrepreneur?	p. 170
Intrapreneurship	p. 174
Challenges Faced by Entrepreneurs	p. 175
Important Considerations for Nurse Entrepreneurs	p. 176
Marketing Your Services as a Case Manager, Consultant, or Entrepreneur	p. 183
Introduction	p. 183
Definitions and Concepts: What Is Marketing?	p. 184
Market Analysis	p. 187
The Marketing Plan	p. 189
The Marketing Process	p. 191
Networking	p. 192
Consultation: A Business for Case Managers	p. 197
Introduction	p. 197
Definitions: What Is Consultation?	p. 199
The Skills and Traits of a Consultant	p. 202
Reasons That Clients Seek Consultation	p. 202
The Consultation Process	p. 204
Types of Consultation	p. 205
Interventions Suggested by Consultants	p. 207
Overcoming Resistance	p. 209
Examining Organizational Dynamics	p. 209
Choosing a Career as a Consultant	p. 211
New Trends in the Evolution of Case Management: Faith Community Nursing	p. 219
Introduction: Historical Perspectives	p. 220
The Philosophy of Faith Community Nursing	p. 223
Conceptual Frameworks for Faith Community Nursing	p. 224
Collaborative Practice: Building Partnerships	p. 224
Faith Community Nursing: Roles, Functions, and Skills	p. 230
Standards of Practice	p. 231
Quality of Care	p. 236
Disease Management	p. 241
Introduction	p. 241
Introduction to Disease Management	p. 242
Historical Perspectives: Disease Management's Evolution and Future	p. 243
Characteristics of a Disease Manager	p. 247
The Value of Healthcare Delivery by a Disease Manager	p. 251
The Components of Disease Management	p. 252
Disease Management Strategies	p. 253
Telehealth	p. 263
Introduction	p. 264
Historical Perspectives	p. 264
Strategies for Applying Technology to Case Management	p. 266
Telephonic Case/Disease Management: An Overview of the "On-Demand" Model	p. 269
The Telephonic Case/Disease Management Process	p. 270
Remote Patient Monitoring: Technology in Home Care	p. 273
Home Care and Technological Devices	p. 275
Case Management Information Systems	p. 276
The Benefits of Telehealth from the Patients' Perspective	p. 277
Outcomes Management	p. 281
Introduction	p. 282
The Roles and Functions of the Case Manager	p. 284
Concepts Related to Outcomes Management and Measurement	p. 284
Outcomes Measures and Indicators	p. 285
Historical Perspectives on Outcomes Management	p. 288
Outcomes Measurement	p. 291
Considerations When Establishing Outcomes Management Programs	p. 292
The American Nurses Association Report Card	p. 292
The Environmental (Organizational) Culture in Nursing	p. 294
Tools, Instruments, and Indicators for Home Health Care	p. 295
Outcomes Measurement in Acute Care Settings	p. 296
Other Measurement Tools for Determining Quality	p. 298
Program Evaluation	p. 301
Ethical Issues in Nursing Case Management	p. 309
Introduction	p. 309
Core Values in Nursing Practice	p. 312
Philosophical Models for Ethical Decision Making	p. 313
Ethical Principles	p. 316
Ethical Challenges in Case Management	p. 318
Making Ethical Decisions	p. 322
Characteristics of Ethical Competence	p. 323
Ethics Committees	p. 326
Legal Issues in Nursing Case Management	p. 333
Introduction	p. 333
Definitions	p. 334
Key Legal Terms in Health Care: Malpractice, Liability, and Negligence	p. 336
Nurses and Nurse Case Managers: Standards of Practice	p. 341
Legal Issues and Concerns	p. 343
Legal Issues and Nursing Case Management: A Review	p. 349
Index	p. 355
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Introduction to Care Coordination and Nursing Management

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