Cost Indicators
This indicator measures the average cost per patient managed, factoring in all expenses.
What is Cost per Case Managed?
This indicator assesses if patients are readmitted to the hospital within a certain number of days.
What is Hospital Readmission Rate?
This score reflects patients’ perceptions of their case managers’ support, communication, and responsiveness.
What is Patient Satisfaction Score?
This step in problem-solving is when you find the next best intervention and adjust as needed.
What is step 4
This field aims to improve the health and well-being of individuals with multiple chronic conditions and social barriers
What is complex case management?
A shorter length of this typically indicates efficient care delivery.
What is Length of Stay (LOS)?
Achieving targets for this indicator reflects the effectiveness of case management in helping patients manage chronic diseases.
What are Patient Outcomes?
This indicator monitors how actively patients participate in managing their health.
What is Patient Engagement Rate?
This step in problem-solving is the variance analysis where you identify the problem
What is step 1
This approach emphasizes using consistent language, addressing social determinants of health, and connecting patients to local resources like food banks and support groups. Additionally, it includes setting achievable goals with patients and maintaining continuous monitoring to adapt care plans as needs evolve.
What is addressing complex patients?
This type of visit is considered unnecessary if primary or preventive care could have been used instead.
What is an Avoidable Emergency Department Visit?
The percentage of patients who follow their prescribed medication and lifestyle recommendations measures this.
What is Care Plan Adherence?
Case managers use this measure to gauge a patient’s knowledge, skill, and confidence in managing their health.
What is Patient Activation Measure (PAM)?
This problem-solving technique requires you to focus on the desired outcomes
What is step 3
When addressing the needs of people with complex health and social needs, providers often face barriers such as the impacts of trauma, dismissive care, cultural mismatches, inadequate social networks, and systems that are hard to navigate. Other obstacles include under-resourced community services, unsupportive neighborhoods, and pervasive structural discrimination.
What is common barriers to providing effective care for people with complex needs?
This is the typical benchmark range for cost per case managed in hospital settings.
What is $300-$1000 per case?
For general inpatient populations, the target benchmark for 30-day hospital readmission rates is to stay below this percentage.
What is 15%?
Surveys like HCAHPS often aim for this percentage to reflect high patient satisfaction.
What is 75-90%?
This problem-solving technique requires the CM to test and evaluate the plan
What is step 5
In cases where a patient like Laura experiences setbacks or crises related to memory impairment or impulsivity, the case manager needs to have clear strategies in place. These strategies should focus on immediate intervention and adjusting the care plan to meet evolving needs. What are some key strategies for managing crises or setbacks in a complex care setting?
What is crisis intervention techniques, including adjusting care plans, increasing support services, and ensuring timely communication with the care team?
Nationally, hospitals aim for an average LOS of this range in days for general admissions.
4.5-5 days?
The overall benchmark adherence rate, which includes medication, appointments, and lifestyle changes, typically aims to be within this percentage range.
What is 75-80%?
The benchmark range for patient engagement in self-management programs or care recommendations typically falls between these percentages.
What is 70-85%?
This problem-solving technique allows for brainstorming alternate strategies or approaches by encouraging creativity
What is Step 3
Theodore, a 62-year-old with major depressive disorder, anorexia nervosa, and alcohol dependency, faces numerous challenges, including non-adherence to medical advice, housing instability, and frequent hospitalizations due to alcohol-related issues. What are the key lessons learned from this case in the role of case managers when coordinating care for patients with multiple chronic conditions and social barriers?
What is
-the importance of a multidisciplinary team-based approach
-the need for frequent communication and support
-proactive intervention to address housing instability
-continuous monitoring to ensure patient stability and progress?