Case Management is the nursing involved with the business of length of stay. Incorporation of InterQual or another ranking system, the CM determines length of stay based on numerous factors. There are also other CM models so individual jobs will vary. Specialties Case Management Article
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Case Management encompasses several models depending on the work environment. In the hospital, the Nurse Case Manager (CM) is frequently utilized to determine the length of stay and incorporating individual patient dynamics into the equation.
Interqual (an evidence-based clinical decision support solution) is the resource most facilities use to determine the qualifications of patients with regards to their admission length. Nurse Case Managers work with physicians, other nurses, ancillary personnel as well as the patient themselves. Interqual is a proprietary program that is sold by McKesson and purchased by facilities.
Case Management encompasses risk management as it relates to the patient's length of stay. With the drawing down of hospital personnel and the tightening of purse strings across the board, CMs are seeing expansion of their roles in the hospitals. Some CMs are even doing discharge planning.
Another CM model is that of the RN responsible for a set of patients that are at high risk for readmittance to the hospital. The CM works with them to determine why they are at high risk and works to alleviate these barriers.
Case Management (CM) usually takes place in an office setting and work hours are usually Monday-Friday dayshift hours. CMs may wear street clothes or scrubs. In larger facilities, CM is a full-time position while in smaller facilities, you might only be employed part-time. Most CMs do not perform bedside care of the patient although they may interact with the patient.
This is needed as the CM often covers several units. Few patients have only one problem when they are admitted so it is necessary for the CM to have varied experiences in order to correctly figure in co-morbidities.
The CM will be inputting information on a computer or tablet in order to determine length of stay. It is also a plus to be able to determine the nuances of a particular diagnosis. For instance, end-stage renal disease (in the US) is usually caused by hypertension or diabetes. The CM will be looking for these diagnoses and associated co-morbidities such as (for example) neuropathy, retinopathy, and cardiac disease.
The CM has to be able to develop a rapport with many types of people from the attending physician, to the social worker, dietician, bedside nurse, patient, and family.
Nursing Case Managers are Registered Nurses with at least an associate's degree in nursing (ASN/ADN). Most will hold a bachelor's degree in nursing (BSN) or a master's in nursing (MSN). Some are MSN-prepared Advanced Practice Nurses such as Nurse Practitioners or Clinical Nurse Specialists. The RN must possess a current, unencumbered RN license in the U.S. state of practice.
According to salary.com, the average Case Manager salary in the U.S. is $80,497 with a range between $73,574 and $88,174.