Case Management for Tribal Health Care

Join us for this class and learn how to develop systems and structures that get better outcomes for your patients. We'll discuss how to create case plans that work, strategies for uncovering hidden patient needs, motivational interviewing techniques that help change patients' behaviors, and how you can best advocate for your patients.

From intake and assessment to discharge and follow-up, we'll walk you through case management across the continuum of care, and help you learn valuable tips and tricks for time management, negotiation, and other practical skills that every case or care manager needs.

T O P I C S   I N C L U D E
Introduction to Case Management
  • Case Management defined
  • Goals of Case Management
  • Guiding principles for case management practice
  • The role of Case Manager
Case Management Process
  • Case finding/screening and intake
  • Assessment of needs
  • Identification of actual and potential problems
  • Interdisciplinary care planning and implementation
  • Evaluation of patient outcomes
  • Patient's discharge and disposition
  • Repeating the case management process
  • Following up on patient post-discharge
Skills for Successful Case Management
  • Advocacy skills
  • Clinical reasoning and critical thinking
  • Negotiation skills
  • Health literacy
  • Using teach-back methods
  • Communication and interpersonal skills
  • Emotional intelligence
  • Data management
  • Motivational interviewing
Strategies for Case Managers for:
  • Effective time management
  • Better patient care management
  • Effective patient/family education
  • Successful negotiation
  • Advocating for patients/families
  • Improving patient care quality
  • Instituting effective change
  • Providing holistic patient care
  • Providing effective counseling
  • Changing patient behavior
  • Sustaining change behavior
Case Management Plans of Care
  • Overview of case management plans
  • Types of case management plans
  • Advantages of case management plans
  • Process of developing case management plans
  • Patient and family case management plans
  • Strategies for getting physician buy-in
  • Guidelines for the development of case management plans
Providing Quality, Safe Patient Care
  • Defining what "quality" care is
  • Setting the standards
  • DMAIC Six Sigma process
  • Using structure/process outcomes to measure quality
  • Organizational values
  • Case management and continuous quality improvement
  • Consumer/patient experience and satisfaction
  • Hospital Value-Based Purchasing
  • Meaningful use
  • Cost/quality/case management
  • Outcomes management
Case Manager's Documentation
  • Why documentation is so important
  • Important aspects of documentation
  • Timing and frequency of documentation
  • Electronic medical records
  • Elements to include in documentation
  • Elements of documentation in telephonic triage/case
  • Elements of the intake note
  • Elements of the initial assessment note
  • Identification of the patient's actual and potential problems
  • Establishing and implementing the plan of care, with outcomes
  • Coordinating care activities
  • Patient and family teaching
  • Patient's discharge and disposition
  • Evaluation of patient care outcomes
  • Documenting variances
  • Charting by exception system
  • Documenting patient education
Transitional and Discharge Planning
  • Case Management Society of America's standards
  • The continuum of care:
    • Pre-acute
    • Acute
    • Post-acute
  • Determining the level of care
  • Matching patients to the level of care
  • Managed care and the level of care
  • Transitional planning process:
    • Assessment of patient's condition, risks and needs
    • Development of transitional plan, including treatment and discharge goals
    • Implementation of the plan
    • Evaluation and ongoing monitoring of the plan
    • Confirmation of the plan and final preparation for patient's discharge
    • Discharge/transfer
    • Following up on the patient
  • Transferring patients to other facilities
  • Strategies for successful transitions of care
  • Medicare Hospital Readmission Reduction Program
  • Care transition models to enhance care and reduce readmissions
Chronic Care Management, Medicare Part B
  • CCM and Complex CCM
  • Best practices:
    • Develop an implementation plan and business model
    • Designate a program coordinator to implement and obtain reimbursement for CCM
  • Eligibility requirements
  • Examples of CCM services
  • CPT codes
  • Restrictions on concurrent billing
  • Offering CCM in conjunction with other Medicare benefits
  • Documentation requirements

*Topics subject to change.

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