solved

Question
Answered step-by-step
Asked by khanimova94

Case Management Course 

Select Two Care Settings

Compare and contrast the role of the Case Manager in safe transitions of care from two different settings – be specific.
What can a Case Manager do to enhance patient safety when a patient is transferred from one level of service and/or care to another?
Describe three challenges to this process and provide three specific recommendations and your rationales.

Hello I finished the assignment. I need help with you telling me if I did it correctly and if I made any mistakes. If I made any mistakes can you please point them out and fix it. Thank you

Question 1
In order to ensure a safe transition of care, a case manager must understand the differences between the settings. 

A patient’s transitioning from the hospital (acute care) to a skilled nursing facility (post-acute), would need to make sure that all required paperwork is finished. Transition of care from hospital to the SNF includes assessment of insurances coverage/criteria. Powell states “Traditional Medicare patients (those reimbursed under the DRG system) may enter an SNF level of care when certain criteria have been met: 
The patient must be in the hospital for three consecutive days, also referred to as the 3-Midnight Rule. (This criterion is not required for the Medicare Advantage Plans.)
The 3-day stay must have been medically necessary.
The SNF reason for admission must also be congruent with the reason the patient was in the hospital; or
Posthospital SNF placement may take place within 30 days of hospital discharge” (Powell & Tahan, page 286, 2019)
Another example of a case manager assisting a patient with transition from different settings is a home health case manager. He/she assists the patient with transitioning from multiple settings within the community such as rehabilitation services, HCP offices as well as receiving services.
 Case managers responsibility is to assess the patient insurance plan and work with the insurer to provide multiple services. Powell states, “Medicare model, covered home services include Physical or Speech Therapy. PT and ST may be added if skilled nursing services have been assessed and they are deemed reasonable and necessary. 

Other responsibilities of the case manager within the community setting are to make referrals, follow up appointments and offering the family information and support. 

Question 2
When a patient is moved from one level of service and/or care to another, a Case Manager can take a number of actions to improve patient safety. Some of these things are as follows

1. Ensuring that the patient receives all necessary medical information.
2. Ensuring that any particular requirements or worries the patient may have been communicated to the receiving facility’s employees.
3. Following the transfer, checking in with the patient to make sure they are adjusting well and that all of their needs are being addressed. (Powell & Tahan, page 499, 2019)

Question 3
The following three obstacles to the process:

1. Ensuring that patients receive the care they require quickly, Teper states, “If patients are not adequately transitioned between care settings, they run the danger of not getting the help they require quickly” (Teper, 2020).

2. Ensuring that patients receive the right care, Teper states “If patients are not effectively transitioned between care settings, they run the risk of not receiving the right care “(Teper, 2020).

3. Ensuring that patients are at ease with the care they receive Teper states, “If patients are not effectively transitioned between care settings, they may not feel at ease with the treatment they receive.” (Teper, 2020).
The three recommendations are as follows:
1. Ensure adequate communication and collaboration. Busari states “Team collaboration is essential. When health care professionals are not communicating effectively, patient safety is at risk for several reasons: lack of critical information, misinterpretation of information, unclear orders over the telephone, and overlooked changes in status” (Busari, 2017)

2. Use a discharge checklist. According to Busari, the point is not to replicate information but to ensure that amid the heightened activity in the planning stage and pre-discharge, vital aspects of the planning are not missed (Busari 2017)

3. Educate and involve the patients through the process of transitioning between different settings. HHS sates, “case managers should include patients and their caretakers to ensure their individual goals and preferences don’t get lost in the process” (HHS, 2022).

 

References

Busari, J. O., Moll, F. M., & Duits, A. J. (2017, June 10). Understanding the impact of interprofessional collaboration on the quality of care: A case report from a small-scale resource limited health care environment. Journal of multidisciplinary healthcare. Retrieved August 2, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472431/ 

Case management: Discharge planning: HSS orthopedics. Hospital for Special Surgery. (n.d.). Retrieved August 2, 2022, from https://www.hss.edu/case-management-discharge-planning.asp 

Powell, S. K., & Tahan, H. M. (2019). Case management A practical guide for education and practice. Wolters Kluwer Health.

Teper, M. H., Vedel, I., Yang, X. Q., Margo-Dermer, E., & Hudon, C. (2020, July). Understanding barriers to and facilitators of case management in primary care: A systematic review and thematic synthesis. Annals of family medicine. Retrieved August 2, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358023/ 

 

 

SCIENCE
HEALTH SCIENCE
NURSING

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."