Survival Strategies For Nurses In Managed Care

This book helps nurse managers define their role in the managed care system, learn strategies in financial management and focus on preventative care, while working on re-engineering patient care delivery systems, utilization, and outcomes management. It addresses topics from defining managed care andexplaining how a company works, to addressing ethical and legal issues that arise in the managed care system.

This practical, "hands-on" guide includes vital information every case manager and administrator of a case management program need to be successful. A useful resource for working in the changing face of healthcare, it addresses case managers in all settings with an emphasis on nurse case managers and their role in providing patient care and containing costs. Focusing on the "nuts and bolts" aspects of case management, it discusses the operations of case management programs based on the authors' first hand experiences. Case Management Tip boxes in each chapter highlight important tips and provide easy access to this information. Case studies in several chapters address possible situations the case manager may confront along with the most effective solutions. Key points at the end of each chapter summarize pertinent information. Appendices provide extensive examples of forms and multi-disciplinary action plans used in various healthcare settings.

The best-selling Chronic Illness: Impact and Intervention continues to focus on the various aspects of chronic illness that influence both patients and their families. Topics include the sociological, psychological, ethical, organizational, and financial factors, as well as individual and system outcomes. the revised Sixth Edition includes new chapters on palliative care, complementary and alternative therapies, and self-efficacy, as well as added material on culturally competent care. Intended for nurses, social workers, and rehabilitation professionals, Chronic Illness demonstrates how the h

Of all the recent changes in health care, none have more dramatically affected both patients and care providers than managed care. Not only has it altered the way we pay for health care but also it has compelled a change in the way we approach health care, focusing increasingly on preventive care to reduce costs. In Managed Care, Dr. Margaret M. Conger and her colleagues examine the impact of managed care on nursing as a profession and nurses as individual caregivers. Organized into three sections, Managed Care looks at the nature of managed care, nursing strategies in acute care hospitals, and nursing strategies in community settings. Section I examines the evolution of managed care, definitions, and issues informing this method of service delivery, and nursing involvement in quality of care and case management. In Section II, the authors look at acute care settings, discussing the use of nurse extenders, advanced practice nursing, case management, automated clinical pathways, and outcome research. Section III addresses the community settings and explores case management, advanced practice roles in community health clinics, and collaboration in primary care settings. Managed Care will serve as an excellent course text on nursing and managed care, as well as being a useful introduction and shelf reference for professional nurses at all levels.

Revised, updated, expanded edition of essential book for case managers in nursing, healthcare and other professional disciplines New information on the ACA, value-based purchasing, accountable care organizations, emerging reimbursement methods, transitions of care, changing accreditation standards and much more A proven textbook for university courses, CCM exam prep, and continuing education Hundreds of case studies, finance formulas, practical pointers and sample problems The third edition of this important book adds over 10 years of new data, facts and experience needed by professional case managers, administrators and students of case management. This new edition incorporates the impacts of the Patient Protection and Affordable Care Act, value-based purchasing methods, care coordination strategies, transition planning, and case management software. Like the previous editions, the book is written to assist the professional and student, especially in the field of nursing, with practical guidance for understanding and mastering the techniques of managing cases in multiple healthcare settings: pre-acute, acute, and post-acute. At once practical and comprehensive, the new and expanded edition provides recent financial, legal and medical information required by case managers to succeed in the evolving environment of healthcare delivery. The result is an essential resource for individuals and interdisciplinary teams from many professional backgrounds, who can use the know-how in this volume for coordinating care, containing costs, and improving quality and the patient experience. The Case Manager's Survival Guide is also a proven textbook, used by hundreds of instructors and students in university and continuing education courses, as well by those preparing for the CCM exam.

A clear, concise, hands-on guide to useful, practical tips and techniques to ease the transition from staff nurse to staff manager. The book includes stress generated by the reorganizing and restructuring occurring in healthcare facilities, and examines major healthcare issues, as well as concerns related to managed care. 6 illus.

This text contains the core body of knowledge for case management practice as delineated by the Case Management Society of America (CMSA), the largest professional organization of case managers. The core curriculum provides a "synthesis of case management evolution," and presents essential elements, concepts, and vision for current and future case management practice. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references.

'The Clinical Placement' is a survival tool for nursing students and those that support them throughout their clinical learning journey: mentors, facilitators, academics, clinical partners and registered nurses.