Please provide complete answers to the 5 questions below. Keep answers short, succinct and to the point.
1) Describe two practice settings for RN Case Management. Discuss the goals for case management in that setting, and the key functions of the RN Case Manager in each of those settings.
2) Identify the most important competencies and /skills for case management. Why are these so important to successful role performance? How is this skill important to staff nurses?
3) The three links below are articles on the impact and management of individuals with multiple chronic conditions. http://www.hhs.gov/ash/initiatives/mcc/mcc_framework.pdf
http://www.nytimes.com/2011/02/22/health/22brody.html?_r=3&ref=health
http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/12/31/moving-outside-the-hospitals-four-walls
Read the articles and respond with your observations based on the articles. Include the following elements:
What is the impact and magnitude of the health care needs of individual with multiple chronic conditions on the health care system and our economy?
What do the articles identify as the most critical changes that need to be made in the management of multiple chronic conditions and trends for the future? Why?
Knowing more about the health care system, history and challenges in the United States, what barriers exist to implementing the strategies outlined in the articles?
What strategies can you implement as an RN and how? What condition/s would be your priority? How would you coordinate these across the continuum?
What is the role of palliative care and hospice in chronic conditions care?
4) The Links below discuss the recent changes to Medicare reimbursement based on prevention of readmissions and quality of care
http://www.kaiserhealthnews.org/stories/2011/july/30/medicare-and-hospital-readmissions.aspx
http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/08/09/hospitals-focus-on-maximizing-medicare-payments-by-minimizing-readmissions?
Value based health care
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=3947
Please review and respond to the following questions:
Medicare will no longer pay for readmissions for the same condition within certain time frames
• What is the care implication for hospital care during the first admission?
• What is the role of nurses and nurse case managers in preventing readmission and coordinating care along the continuum?
Medicare payments will be based on the hospital meeting specific quality standards for care
• What is an example of one of these quality standards?
• What is the role of the staff RN and the RN case manager in meeting quality standards?
• How are checklists used in achieving quality outcomes?
Medicare payment will be based in part on measures of patient satisfaction
• What are these patient satisfaction measures?
• What is the role of nursing in achieving these?
5) What is Utilization or Resource Management?
• Why do hospitals or other care settings utilize RNs in a Utilization or Resource Management role?
• Describe the decision support tools utilized by Utilization Management or Resource Management RN’s
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