Collaboration for Improving Outcomes

Course Descriiption
This course covers current topics and trends in Nursing Case Management. This course will
cover a wide array of topics including disease navigation and demand management. The
course focuses on the nurse’s role in a collaborative team approach utilizing both acute and
community settings. The course offers a cumulative
final project whereby the student
chooses his or her patient population and builds the project on that speci
fic patient/disease
type.
Course Competencies
Upon completion of this course, students will be able to:
1. Assess the roles of the nurse case manager in the contemporary health car
e
structure.
2. De
velop a holistic case management plan for a speci
fied disease or population that
incorporates the role of insurance, health care
finance, and utilization of community
resources.
3. Examine the role of case management in end-of-life care including ethical and legal
issues.
4. Coordinate the care of individuals across the lifespan utilizing principles and
knowledge of interdisciplinary models of care delivery and case management.
Additional Instructions: ● All submissions should ha
ve a title page and reference page.
● Utilize a minimum of two scholarly resources. ● Adhere to grammar, spelling, and punctuation criteria. ● Adhere to APA compliance guidelines. ● Adhere to the chosen Submission Option for Delivery of Activity guidelines.
Activity 1 (4 -page paper. Include title and reference pages)
Case Management Implementation Plan
Create a plan to implement case management at your workplace. What is your recommended plan for the use of case managers in your organization for patients with your
chosen chronic illness? Identify people within your organization who are stakeholders or
would support your plan. Whose support do you need to get your plan implemented? Identify your goals – what do you hope to accomplish with your case management plan?
Often, starting with our goals helps – it’s a backward design. As we think about a case
management plan we are proposing for our workplace, what do we want to accomplish?
Remember – goals should be measurable. For example, if the chosen chronic disease is
diabetes, one goal may be: ● Clients will have decreased incidences of hyperglycemia requiring hospitalization
Once we determine what we want to accomplish, we can begin to construct our plan t
o
achie
ve the goal. To achie
ve this goal, our plan may include pr
oviding education in a manner
the client can understand (being sensitive to cultural needs), access to phone support, or
inputting glucose readings into their electronic health record for documentation the case
manager can e
valuate and use to reach out to the client.
To put this plan in action, whose support would we need? Primary Care Physicians,
Utilization Review personnel, and the Chief Financial O
fficer would all ha
ve an interest in
optimizing patient health and reducing costs.
Reading and Resources
Read Ferrier, G. D., & Trivitt, J. S. (2013). Incorporating quality into the measurement of
hospital e
fficiency: A double DEA approach. Journal of Productivity Analysis, 40(3), 337-355.
https://search.proquest.com/docview/1448800469?accountid=169658
Search the site for US Department of Health and Human Services “Hospital Compar
e” and
use the interactive database to compare and contrast health plans, hospitals, etc. How might you use this site with patients as a case manager?
Activity 2 (4 -page paper. Include title and reference pages)
Chronic Disease Management
Choose one of the following chronic diseases to address in this component: ● Hypertension ● Chronic Obstructive Pulmonary Disease ● Diabetes Mellitus type 2 ● Childhood Asthma
Complete the following: ● Detail the population including who the members are, contributing causes, past
medical histor
y, family/genetic components.
● E
valuate the population including size, seriousness of disease, special needs, etc.
● Assess the need for formal case management. ● Argue the potential benefits to implementing a case management model including
economics, quality of life/care, social disruption, etc. ● Analyze why nursing should be a part of this plan. What can they bring to the table? ● Identify other team members who should be included on a case management team.
Why should they be on this team and what is their role?
Reading and Resources
Chapter 2 pages 44-47 in Fundamentals of Case Management Practice
De Regge, M., Pourcq, K. D., Meijboom, B., T
rybou, J., Mortier, E., & Eeckloo, K. (2017). The role
of hospitals in bridging the care continuum: A systematic r
eview of coordination of care and