Campus Collusion
Review Questions for Test Preparation

       
    

  



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

Review Online for Free
Lies about Study Techniques: Believe them at your own risk.
www.NursingInAFlash.com

Page 4
Skip Navigation Links
Question Answer
What is the impetus for a revision of a critical pathway/care plan management?
Show Answer
A body of evidence that supports an adjustment
How is a care map different from a critical pathway?
Show Answer
A care map is a guide to the collection, interpretation and integration of evidence as well as care planning activities that should be performed. A critical pathway is essentially a step-by-step plan for coordinating care based upon a diagnosis
What is the Brown BPHM?
Show Answer
It is a care map, it stands for Best Practice Health Care.
What are the characteristics of the BPHM?
Show Answer
It is client centered, scientifically based, population outcomes based, refined through quality assessment and comparison to other maps, individualized to each client and compatible with the larger health care system
What are some characteristics a disease management plan may possess?
Show Answer
-Case management and risk sharing arrangements between payers/providers -Programs for monitoring the use of prescriptions and treatment interventions to assess outcomes and costs -protocols for clinical and administration processes -education initiatives r/t cost effective treatments -interventions to modify health behaviors and increase compliance with treatment regimens
What are the factors that impact solutions in a case management process?
Show Answer
Medical necessity, costs, limits, exclusions, care quality, case standards, other care providers, insurance regulations, HMO management, DME suppliers, family members, and PCPs
What are the benefits of disease management programs?
Show Answer
They allocate correct resources in an efficacious manner, produces higher levels of wellness in shorter amounts of time, is holistic, will ensure cost-effective, optimal clinical care across the continuum
What is a life care plan?
Show Answer
A tool used to assess the current and future needs of a client for catastrophic or chronic disease over a life span.
__________ is a customized, medically based document that provides assessment of all present and future needs (including financial, medical, spiritual, vocational, psychological, social and physical) including services, equipmentm supplies and living arrangements for a client.
Show Answer
Life Care plan
When are life care plans typically utilized?
Show Answer
When a client is experiencing catastrophic illness or adverse events resulting from professional malpractice. It is used to analyze damages by either a plantiff or defendent in law proceedings.
Download these questions to your phone here
What are the phases of the development of a life care plan?
Show Answer
First: A thorough assessment of the client, financial/billing agreements, information released by the client and targeted dates for report completion Second: plan development based on social situation, leisure activities, educational/employment status, medical history, physical abilities, current status and assistance needed for ADLs.
What actions can ensure high-quality care?
Show Answer
-provide access to easily understood information -provide access to appropriate specialists -ensure continuity of care -provide access to emergency services where/when needed -disclose financial incentives that could influence medical decisions/outcomes -prohibit gag clauses -provide antidiscrimination practices -provide internal and external appeal processes to solve client grievances
What is the function of a life care plan?
Show Answer
To portray the needs of the client that are consistent with the changes in the client's life over the predicted lifespan taking into account the injury or diagnosis
What are some identified benefits of case management?
Show Answer
Provides objective advice and assistance for care needs, provides access to multidisciplinary providers and services, serves as a way to ensure payers' funds are being spent on those with the most need, and serves as a policy assurance and accountability function for communities.
What types of agencies are designated within states to carry out case management functions?
Show Answer
District offices of state goevernments County social services offices Private contractors
Why do states maintain the oversight responsibilities of case management facilities?
Show Answer
To ensure they are complying with program standards, including contracts, reporting and fiscal controls; to identifying emerging issues and problems that may need additional policies, and to provide on-site technical assistance and consulting to improve performance.
What are the three types of case management models?
Show Answer
Client focused, systems focused and social service models
__________ case management models are focused on the relationship between a case manager an client to support continuity of care and access to providers of care.
Show Answer
Client focused models
_________ case management models are focused on addressing the structure and processes of using population-based tools of disease management and critical pathways to offer care for client populations.
Show Answer
Systems focused models
_________ case management models provide services to clients to assist them in living independently in the community and maintaining their health by eliminating or reducing the needs for hospital admissions or long term care.
Show Answer
Social service models
What are some examples of conditions that are served by case management?
Show Answer
AIDS Amputations Cerebrovascular accidents Chronic diseases/disabilities Coma High risk neonates multiple fractures Severe burns Severe head trauma Spinal cord injury Substance abuse Terminal illness Transplantation Ventilator dependency Work related injuries
  
Page 4 Skip Navigation Links
Not what your looking for, continue searching

    
Skip Navigation Links