Review various definitions of “case management” as provided by your textbook and other internet sources. Differentiate between case management, disease management, and population health management
Review various definitions of “case management” as provided by your textbook and other internet sources. Differentiate between case management, disease management, and population health management. Describe how case management services affects the health and well-being of the patient and their future encounters with the health care system.
OR
A number of models of case management have been developed to identify and meet health care needs through quality, cost effective services. Explore the case management models discussed in your textbook and research a model of your choosing in the literature and provide an example of how this model benefits the client and the health care system.
N684 Case Management and Home Health Services
Module 2 Discussion
Choose one of the following prompts to answer:
Cultural competency and advocacy are listed as skills necessary for effective case management. Define cultural competence and advocacy and then provide an example from your practice that demonstrates your skill level in that area.
OR
As a case manager, you are responsible for assisting with care transitions. Outline a discharge plan from the hospital to home care services for the following client: Mr. Perez is a 72 year old Puerto Rican male being discharged from your hospital with an exacerbation of Congestive Heart Failure. He has been hospitalized three times in the past 90 days. He lives alone and has limited family support. He understands English; however, he prefers to communicate in Spanish. This is his first referral to home care services. Medicare is his primary payor source. As you develop your discharge plan, identify areas that you will focus on with the home health agency to decrease the likelihood of readmission to the hospital.
N684 Case Management and Home Health Services
Module 3 Discussion
Reimbursement challenges in healthcare increase the need for case management services to reduce the cost of care, but also to ensure care is delivered in a safe and efficient manner. Conduct a literature search focused on health promotion and illness and injury prevention; identify an article that addresses the effectiveness of case management on these priorities. Summarize the article.
N684 Case Management and Home Health Services
Module 4 Discussion
Identify a situational constraint that might prevent a client from following through on a referral to an outside agency. Discuss how the case manager can take action to eliminate or minimize the effect of the constraint so that the client can benefit from the intervention.
N684 Case Management and Home Health Services
Module 5 Discussion
The home and community are increasing in importance as the recommended point of care delivery. Identify a recent news article that supports this assertion. Summarize the article and discuss how this information will influence and support the patient and family in achieving the best possible outcomes while remaining in the community. Provide a link to the article you have chosen for this discussion post.
OR
You are a home health nurse and your agency has received a referral for an elderly male with congestive heart failure. Discuss how the determinants of health (biological, psychological, environmental, sociocultural, behavioral, and health system) can influence the client’s overall health status.
N684 Case Management and Home Health Services
Module 6 Discussion
Choose one of the following prompts:
Home health nurses, their organization, and the home health care industry have faced many challenges in the last several years. Research trends, issues, and opportunities related to the home health care industry; identify one area for discussion and present a summary of your findings.
OR
Discuss how pay-for-quality performance initiatives are influencing home health care delivery.
N684 Case Management and Home Health Services
Module 7 Discussion
Choose one of the following prompts:
Survey the literature and identify a research article that addresses one of the following areas of study:
• The use of advanced practice nurses in home health.
• Preventing rehospitalization among home health care clients.
• Fall risk identification, impact of falls, and interventions for the homebound client.
Read the article and provide a summary of the research for the chosen area of interest. Provide a link to the research article being summarized.
OR
Discuss how telehealth technology is influencing the practice of home health nurses and transforming home health agency operations.
N684 Case Management and Home Health Services
Module 8 Discussion
Choose one of the following prompts:
Changes to reimbursement and payment structures over the last few years have proven to be challenging to home health agencies. Discuss why home health agencies must examine their practices and payor mix to remain viable in today’s environment.
OR
As the Administrator of a Medicare certified home health agency you are responsible for analyzing and controlling cost variances to maintain agency viability. Identify three metrics you would use to analyze agency financial performance on a daily basis. Discuss why you have selected these metrics.
N684 Case Management and Home Health Services
Module 1 Assignment
The Professional Development Assignment should be between 1500 and 2000 words with minimum of two sources from the literature outside of your textbook for this course.
You are a population health nurse working with congestive heart failure clients (greater than the age of 65) who receive services from your hospital.
From a population health management perspective, identify services and interventions that address the health needs of this particular population. Your exploration with this particular population should include cost-effective interventions that address health promotion and illness prevention, risk management, care coordination, and disease management.
N684 Case Management and Home Health Services
Module 2 Assignment
Create a PowerPoint™ presentation that explores the ethical and legal issues in Population Health Management. Your slide presentation should contain no more than 10 content slides (excluding the title and reference slides) and should include two scholarly references outside of your textbook.
N684 Case Management and Home Health Services
Module 3 Assignment
Examine the literature related to case management for clients with HIV/AIDS. In a scholarly submission of 1500 to 2000 words, answer the following questions. Your submission should contain a minimum of three references.
1. What does the evidence indicate overall regarding the effectiveness of case management for this condition and client population?
2. Are there client-or population related factors that influence the effectiveness of case management strategies? How might these factors be modified to promote more effective case management?
3. What health promotion, illness prevention, problem resolution, and health restoration activities might be appropriate in dealing with the problem of HIV/AIDS client population? Which of these activities might you carry out yourself? Which would require collaboration with other community members? Who might these other people be?
N684 Case Management and Home Health Services
Module 4 Assignment
Choose one population-specific case management issue in Chapter 12 of the Clark textbook that interests you. Find a research article addressing this topic and write an article critique. Then, search for three more articles to support the application into practice. Your submission should be an APA formatted essay of 1500 to 2000 words and include a minimum of four (4) references outside of the text for this course.
N684 Case Management and Home Health Services
Module 5 Assignment
This scholarly submission should be at least 1500 words and should contain 2 sources outside of the materials used for this module.
The graduate level nurse is well suited to assume many different roles within the home health agency. Review the clinical and administrative roles outlined in the following article:
Scope and standards of practice for registered nurses in care coordination and transition management. (2015). Retrieved from ProQuestEbook Central.
To find the titles, you can click into ProQuestEbook Central, linked on the library page, A-Z list of databases and search for the book titles enclosed in quotation marks.
Choose a clinical and administrative role that is of interest to you and discuss how these roles, their associated responsibilities, and functional areas contribute to effective home health care delivery.
N684 Case Management and Home Health Services
Module 6 Assignment
Read the following case study and submit a 1500 – 2000 word paper that addresses the case study and the questions at the end of the case study.
Mr. B. is an 83 year old male referred to home health services following a hospital admission for congestive heart failure. His payor source is Medicare (traditional). He lives alone and indicates he does not have sufficient financial resources to afford private-pay in home supportive care. His daughter, who lives in the neighboring county about 30 miles away, has offered her father to move in with her – he has refused and she is not “forcing the issue”. Mr. B. is also not open to discussing moving to an assisted living environment.
This is his third hospital admission for the same problem over the last 12 months and his second admission to a home health agency. He was discharged from the previous home health agency 6 weeks ago. Physician orders are for the home health agency to provide skilled nursing for assessment of his cardiac condition and to teach him about his care and medication regime. Physical therapy has been ordered to establish a home exercise program. Home health aide services have been ordered 3 times a week to assist Mr. B. with his personal care needs.
By the end of the third week of service, it is clear to the RN Case Manager that Mr. B. is not making progress to the established goals. She reports during case conference that he is not a good candidate for teaching because of intermittent confusion and forgetfulness. According to the nurse, no matter what she has tried to teach him and regardless of the aids she has used, Mr. B. continues to take is medication incorrectly. She states, “I know he needs services, but I am not sure that he is in the right environment. I am concerned about Mr. B. – I am not sure why his daughter won’t just step up and put her foot down.”
The physical therapist reports at case conference that the “client lacks motivation”. The home exercise program has been established with Mr. B.; however, he does not complete the exercises between therapy visits.
An improvement in his personal hygiene has been noted with the Home Health Aide (HHA) services. The HHA has also been successful in decluttering his living space. The HHA reports that she is concerned that he is not eating regular meals.
This situation offers an ethical challenge to the professional caregivers and to the agency for which they work.
Discuss how you would handle this ethical dilemma. Address the following questions as a part of your response:
1. What are your concerns about this case?
2. How does the RN Case Manager meet her ethical responsibilities to the patient and to the organization?
3. What is the best plan of action to ensure the client’s safety and well-being?
4. What are realistic outcomes and goals for this client?
5. Who will provide the ongoing care needs required by this client?
N684 Case Management and Home Health Services
Module 7 Assignment
For this professional development exercise, submit a 1500 – 2000 word paper. Two resources outside of your text should be used for this assignment.
In the United States, the Outcome and Assessment Information Set (OASIS) data are used for home health regulation, reimbursement, clinical purposes, and research. Debate the validity and reliability of OASIS as a tool in the measurement of patient outcomes, in research, and in quality improvement.
N684 Case Management and Home Health Services
Module 8 Assignment
For this professional development exercise, submit a 1500 – 2000 word paper. Two resources outside of your text should be used for this assignment.
Identify three legislative priorities related to the provision of home health and hospice services. Provide an overview of each issue and discuss how they affect the home care and hospice industry from the perspectives of cost, quality, or access.
N684 Case Management and Home Health Services
Module 8 Reflection Assignment
Please consider how you have developed the knowledge, skills, and attitudes that enable your achievement of the Course Goals listed in the syllabus. Then write a minimum of a 1000 word APA-style essay reflecting on how this course has helped you achieve these goals.
Finally, submit the assignment into the drop-box.
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