Case Management: A Practical Guide for Education and Practice, 4th Edition

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Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition.

Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home.

Build a strong case management career foundation, with expert, evidence-based direction:

• NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools
• NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care
• NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development
• Offers in-depth, evidence-based guidance on:
  • The case manager’s roles, functions, and tasks
  • Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care
  • The role of the nurse case manager versus social worker role
  • Strategies that ensure effectiveness of case management models
  • Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards
  • The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications
  • Management of resources and reimbursement concepts
  • Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation
• Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study
• A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management

About the Authors

Suzanne K. Powell, RN, MBA, CCM, CPHQ, is Editor-in-Chief, of Professional Case Management: Leading Evidence Based Practice Across Transitions of Care at Lippincott Williams & Wilkins in
Philadelphia, Pennsylvania.

Hussein M. Tahan, PhD, RN, is System Vice President of Nursing, Professional Development and Workforce Planning at MedStar Health System Nursing in Columbia, Maryland.

Table of Contents

Part 1 Introduction to Case Management Practice
Chapter 1 Overview Of Case Management
Chapter 2 Roles, Functions, And Preparation Of Case Management Team Members
Chapter 3 Management Of Resources And Reimbursement Systems

Part 2 The Case Management Process and Related Activities
Chapter 4 The Case Management Process
Chapter 5 Utilization Management
Chapter 6 Transitional Planning: Understanding Levels And Transitions Of Care

Part 3 Key Concepts in Case Management Practice
Chapter 7 Quality Management And Outcomes Evaluation
Chapter 8 Legal Considerations In Case Management Practice
Chapter 9 Ethical Principles In Case Management Practice

Part 4 Practical Applications
Chapter 10 Case Management Standards And Professional Organizations
Chapter 11 Preparation For The Case Manager Role
Chapter 12 Strategies For Success In Case Management Practice