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Case Management BasicsPublic Health Nursing Population Centered Health Care in the Community

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Question Answer
__________ management seeks to control use of health care services by providing clients with correct information and education strategies to make healthy choices, use healthy and health seeking behaviors to improve their health status and to have fewer needs of the health care system.
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Demand management
How do the roles of an Advanced Practice Nurse (APN) and Bachelor's prepared nurse differ with respect to community health?
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APN's work with the client/community aggregates, systems of disease, and outcome management processes. BSRNs focus on care at an individual level
What HP2010 objectives can case management strategies help achieve? (6)
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-increase the number of insured persons with coverage for preventative services -increase the number of people counseled about health behaviors -increase the number of people with a usual PCP -reduce the number of families that experience difficulty/delays or complete lack of health care for a member -increase the number of educational institutions that teach health promotion/disease prevention -increase the number of people with long-term needs who have access to long-term services.
What knowledge and skills are required to achieve competency as a case manager?
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-knowledge of community resources and financing mechanisms -written and oral communication -proficient negotiating and conflict-resolving practices -criticial thinking processes to identify and prioritize problems from the provider and client viewpoints -application of evidence based practices and outcomes measures
What are the four activities defined by the Case Management Society of America (CMSA) of case management?
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Assessment, Planning, Facilitating and Advocacy
What is one of the challenging problems of case management in today's world?
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Fragmentation of services which can result in overuse, gaps, miscommunication and costly client outcomes.
How does case management differ in rural settings compared to urban settings?
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In rural settings there are fewer organized community based systems and the distance to the delivery site is greater. Economics, pace/style of life, values and social organizations differ
What are the four barriers experience by case managers working in rural settings?
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-Lack of closeness (distance wise) to care providers -Limited services -reduce emergency services -reduced acute care services
What are a rural resident's barriers to gaining access to case management services?
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transportation (both for nurses and the resident) lack of health insurance or benefits
What are the 4 shared goals of both case managers and providers/clients?
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1-promote quality of services 2-reduce institutional care which maintaining quality care and satisfactory outcomes 3-manage resources using protocols, evidence based decision making, utilization of guidelines and disease management programs 4-control expenses
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What are the components of the case management process during the assessment phase?
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Case finding, identification of incentives for the target population, screening and intake, determination of eligibility, and of course, assessment.
Problem prioritizing and planning to address a community's care needs are what part of the case management process?
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Planning/outcome
Arrangement of delivery of services, monitoring clients during services and reassessment are what phase of the case management process?
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Evaluation
Developing networks with a target population, dissemination of written materials, seeking referrals, and screening are all activities in the _______ phase of the case management process.
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Assessment
Holding interdisciplinary, family and client conferences, determining conclusions on the basis of an assessment and/or using an interdisciplinary team are all activities a case manager performs during the _________ phase of the nursing process.
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Diagnosis
Validating and prioritizing problems with participants, developing activities, time frames and options, gaining consent, and having a client choose an option available are all activities associated with the ________ phase of the nursing process.
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Planning/outcome
Contacting providers and negotiating services and fees are activities performed during the _______ phase of the nursing process of case management.
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Implementation
Coordinating service delivery, monitoring for changes in the client or service status, examining outcomes against goals, examining needs against services, examining costs and examining satisfaction of clients, providers and the case manager are all activities associated with the _________ phase of the nursing process for case management.
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Evaluation
What are the characteristics desired for case manager effectiveness? (7)
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-Qualifications to understand/evaluate specific diagnoses (usually clinical experience/credentials), and to perform financial analysis -Effective communication skills to teach in simple terms -Assertiveness and diplomacy -ability to assess objectively and plan appropriate services -knowledge of available resources and the strengths/weaknesses of each -ability to act as an advocate -ability to act as facilitator/counselor to clients by providing support, understanding, information and inte
What are the types of assessments performed by a case manager?
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Physical/medical, social, functional, psychological and financial
What are the components of the "planning" competency of case managers?
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Goal setting, need identification, service planning and resource allocation
  
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