Case Management Model

[julie1212]

What case management model does your hospital use?? With all of the changes going on in healthcare today, we are looking at changing our model. Like everyone else we need to do more with less.

[nurseprnRN, BSN, RN]

Can you define your terms better, please? Do you mean, the nursing model that you apply to your case management practice (e.g., Orem, Callista Roy, etc.), or some external set of criteria (e.g., Milliman, Interqual), or ... ?

[chemley]

I'm not sure what "model" refers to. I currently am a case manager at a 245 licensed bed level II trauma center. I have approximately 25-35 patients every day. At our facility the case managers are responsible for discharge planning to home, utilization review, and assisting patients with financial concerns. Our social workers are responsible for discharge planning from facility to facility such as higher level of care facilities, LTAC, STR, SNF, counseling and also voucher writer for financial needs. I'm not sure if that helps

[nurseprnRN, BSN, RN]

I wonder if the OP knows that she has responses?

[omsteelo]

I'm not sure what "model" refers to. I currently am a case manager at a 245 licensed bed level II trauma center. I have approximately 25-35 patients every day. At our facility the case managers are responsible for discharge planning to home, utilization review, and assisting patients with financial concerns. Our social workers are responsible for discharge planning from facility to facility such as higher level of care facilities, LTAC, STR, SNF, counseling and also voucher writer for financial needs. I'm not sure if that helps

How do you, as case manager, reconcile a social worker's need to deal with facility transfers? Hmm. Souinds to me the social workers are doing case management.

[nurseprnRN, BSN, RN]

Social workers can do case management. You can look it up. See the CCMC webpage. But that decription looks to me like they are doing discharge planning, is all. Case management, by definition, influences the course of medical care, of which discharge management is only a part.

[d'cm]

Here in NJ things are pretty much the same, nurses do UR and d/c planning to home and SW d/c to SNF. I'm curious as to what changes you are seeing that would require - and not actually dictate - change in your current model.

[julie1212]

Chemly...yes that helps. I also work at a Level II facility. We have one case manager, one UR nurse, and one social worker on 1-2 units depending on the size. The CM's do discharge planning, utilization of services, making sure the orders are appropriate, follow up phone calls after a patient has been discharged (if they score high enough on the risk assessment for readmissions). The social workers are also doing discharge planning and meeting with those with financial needs, etc. Either the social worker or the case manager has to see the patient everyday. Depending on the unit there are between 22 and 26 patients on each floor. There are times when it is quite overwhelming and I was just wondering how other folks out there were doing things and if there was a better way. Thank you for your input!!