Emergency room case managers are active members of the health care team and act as a liaison between the emergency room, hospital, community case management program to improve continuity and efficiency of care (Powell). Case managers coordinate appropriate are care chosen for the class project is emergency room case manager’s role in the preventions and management of asthma. The performance indicators measured are cost of care, quality of care, health status and clinical outcome (Powell). The performance indicators measured are cost of care, quality of care, health status and clinical outcome (Powell). Measuring health outcome is central to assessing the quality of care patient is receiving and outcome measures can be used for quality improvement …show more content…
An effective outcome measures should be valid, reliable, comprehensive, dynamic, flexible, and cogent (Powell). Outcome measurement allows us to determine which process and interventions are effective and which one needs improvement ( Powell). An effective asthma management by case managers in patients condition and patient outcome (MSDHS). The three measurable outcome of asthma management includes improved quality of life, decreased use of resources, and increased patient and family satisfaction. Regardless of the practice settings case managers help to increase access to health care service, reduces health care cost, improved outcomes of the care delivered and over all improve the quality of care (Powell). The categories of outcome indicators are
Valid-The effect seen is actually related to the intervention and is not a random occurrence
Reliable-Measuring what is actually intended to measure; not easy to manipulate; as objective and quantifiable as
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Case managers are collaborative members of the health care team which promote better communication with provider, and advocates for implementation of care plans (effective health care). The resource utilization include frequency of emergency room visit, hospital admission rate, unscheduled office visit, ambulatory care visit, and prescription fulfillment (MSDS). The data can be collected from patient, hospital management of information system database, employer data, school data and insurance and medicaid claims (MSDS). A decrease use of emergency room visit, decrease work days and school days shows that chronic health condition are well controlled and the disease management program is working well and patients are able to enjoy healthy and quality
If patients constantly have to wait an excessive amount of time they will either leave before they receive care or could end up becoming sicker as a result. Donabedian’s three-element model structure, process and outcome have become the gold standard for defining quality measurement (Varkey, 2010). Structure relates to the health care setting, which includes the hospital policies, procedures and design. Process evaluates if the right actions were taken for an intended outcome and how well the actions were executed to achieve the outcome. Outcome focuses on the patient, it measures the patient’s condition, behavior, and response to or satisfaction with care (Varkey, 2010). Although each of these measures focus on different areas, they indicate areas that need improvement. Also, the measurement from structure and process plays an important role in the patient’s outcome. If the hospital has the right staff, equipment and
...well being on their shoulders. If a patient is not doing well in treatment, it is often looked at as what is case management doing wrong. They are relied on to make any changes if a patient is not doing well. I can imagine a lot of case managers getting burnt out, with the pressure of having tremendous responsibility for patients, as well as having to complete several tasks for them. They must fulfill a patients needs on several levels, and do not receive much assistance. I am sure it takes a lot of energy to be in case management, and can, at times, be a thankless job. Working in the mental health field, I see first hand the importance of case management. Kanter helped show me the complexity of what case managers do, and all that they provide for patients. Case management is definitely needed, however, and I am a little surprised it is a relatively new term
The overall goal of performance management is to ensure that an organization and its subsystems (processes, departments, teams, etc.), are optimally working together to achieve the results desired by the organization. Performance management has a wide variety of applications including measuring the leader performance, such as, staff performance, business performance, or in health care, health outcome performance measures. To manage and measure performance of leaders are directed to the organizational strategic goals and mission. The primary reason to measure and manage performance of leaders is to drive quality improvement. The Clinical performance of a leader are derived from evidence-based clinical guidelines and measurement allows an evaluation of an important outcome of care for patients, and it is a proxy to understand the effectiveness of the underlying systems of care. Just as there are evidence-based care guidelines for many conditions, there also are established measures that indicate how leaders has effectively guidelines and has translated to
Performance improvement is vital to patient safety, quality of care, and patient satisfaction. Regular and an objective view at clinical outcomes is important for the nurse practitioner to engage in to ensure that his or her practice. This continual focus on improving outcomes ensures that quality care is being provided and optimal outcomes are met. This capstone project was a critical evaluation of the performance of a large family practice clinic. The goal of this project was to quantify the performance of the providers in the practice in their treatment of diabetes.
Unlike the staff from Trinity Health, the other staff studied cited some drawbacks from these expectations. For instance, Powell et al. (2012) conducted a study on health care providers’ feedbacks on their performance measure(PM) system. While positive outcomes resulted from PM were documented, the staff reported facing the pressure to conform to the requirements of PM. Because PM contains criteria needed to be met and addressed, Powell et al. (2012) concluded that the providers tend to get distracted from giving personalized and individualized care to patients.
the uncertainty of exactly where the error lies. The outcome is supposed to support one
Case management has become the standard method of managing health care delivery systems today. In recent decades, case management has become widespread throughout healthcare areas, professionals, and models in the United States; and it has been extended to a wide range of clients (Park & Huber, 2009). The primary goal of case management is to deliver quality care to patients in the most cost effective approach by managing human and material resources. The focus of this paper is on the concept of case management and how it developed historically, the definition of case management, the components of case management, and how it relates to other nursing care delivery models.
In order to implement strategies effectively the case manager must use key techniques to resolve the issues. Fist; perform variance analysis, which involves taking the issues and breaking it down into smaller ones to find the root problem and cause. Second, Focusing on desired outcomes, which involves identifying data collected, and how the issue can be solved, and identifying limitations. Third, brainstorm alternative strategies or approaches to ensure to choose the best strategy, with optimal result of patient care. Fourth, finding the next best intervention, and finally evaluation of all outcomes. Good communication skills are also important to the role of the case manager. Using techniques such as empowerment, which allows the patients to speak for themselves, and have the time to complete all their thoughts is encouraging to the patient. Establishing trust allows a therapeutic relationship to occur, which essentially facilitates a key in determining the patient’s plan of care. Maintaining respect, and refraining from judgmental body language is important to ensure the patient is comfortable with you. Above all, Active listening to the patient’s and families needs really shows the case manager cares about what they want, and will incorporate this into their plan of care. The
Ensure that effective measurements and monitoring mechanisms are in place to determine whether implemented solutions have yielded predicted benefits and to drive continuous process improvement.
The focus of this paper is case management. Case management has evolved into a diverse profession which includes many disciplines and is exercised in many settings. Case management involves the process of coordinating multiple services on behalf of clients and has been practiced now for several decades. Many disciplines have engaged in case management and identify themselves as case managers. Case managers work with many populations and settings and play an important role in today’s society. The following analysis explores how case management developed, how it is defined, its components, and how it relates to other nursing care delivery models. All these aspects are reviewed with the purpose to show the importance of case management in the health care organization.
A case manager gives assistance to individuals who are in a difficult situation. A case manager does an assessment evaluation to see what kind of issues the client has and or dealing with. After having an assessment done, the case manager can figure out the main priority to focus on. The case manager then advocates suitable options and services for their
Outcome measures will include satisfaction ratings from referring pediatric staff and participating families, wait times for receipt of behavioral health services and the total number of behavioral health visits in medical
Reliability means that a rater or instrument is consistent and reliable in their measurements from trial to trial. When a measurement is reliable it can be reproduced over and over again and still consistently be free from error. However, it is impossible for a measurement to be completely free of error. Therefore, it is important that the measurement error is calculated. This is the difference between the observed and true values. A reliable measure will have a small measurement error.
Asthma is a disease that currently has no cure and can only be controlled and managed through different treatment methods. If asthma is treated well it can prevent the flare up of symptoms such as coughing, diminish the dependence on quick relief medication, and help to minimize asthma attacks. One of the key factors to successful treatment of asthma is the creation of an asthma action plan with the help of a doctor that outlines medications and other tasks to help control the patient’s asthma ("How Is Asthma Treated and Controlled?"). The amount of treatment changes based on the severity of the asthma when it is first diagnosed and may be the dosage may be increased or decreased depending on how under control the patient’s asthma is. One of the main ways that asthma can be controlled is by becoming aware of the things that trigger attacks. For instance staying away from allergens such as pollen, animal fur, and air pollution can help minimize and manage the symptoms associated with asthma. Also if it is not possible to avoid the allergens that cause a patient’s asthma to flare up, they may need to see an allergist. These health professionals can help diagnosis what may need to be done in other forms of treatment such as allergy shots that can help decrease the severity of the asthma ("How Is Asthma Treated and Controlled?").
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...