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2009 CM Writing Contest
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Tuesday, 19 May 2009 15:10 |
 Health Resource Navigation
Case Managing Uninsured Emergency Room Patients
By Di Ucci, MA ED., LPN, Health Resources Navigator, Transylvania Regional Hospital
Imagine that you are an uninsured construction worker with four children, living paycheck to paycheck. While it is a struggle, you manage until an expected “storm” hits — often a health care problem that quickly spirals out of control.
That’s when you head for the local emergency room.
Our community’s hospital has been serving uninsured people in these predicaments for a long time, and the numbers increased in 2008. That’s when I was hired as the new health resources “navigator.” My mission was clear: design, build and implement a program to help low-income, uninsured but frequent visitors to the ER access primary care, improve their overall health, and decrease inappropriate ER visits. In essence, help them navigate from troubled waters back into stable conditions.
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Tuesday, 19 May 2009 14:16 |
 Bridging the Divide
By Beth Lopez, RN, BSN, CCM
Program Manager, Chronic Care/HBA,
Community Care Partners of Greater Mecklenburg
Communication and care coordination between a patient’s primary medical care team and behavioral health care team today is often fragmented and siloed. Reasons for this vary, but it is clear that a failure to coordinate care produces a divide between the two entities, often resulting in poor patient outcomes.
Community Care of North Carolina (CCNC), the primary care case management health care plan for a majority of Medicaid recipients in the state of North Carolina, is making efforts to change this by connecting the primary care provider and the behavioral health provider.
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Tuesday, 19 May 2009 13:22 |
Case Managers in the Emergency Room Setting
By Mary McDonough, RN, MSN, CCM, Clinical Manager, Case Management, Memorial Sloan Kettering Cancer Center
In today’s environment, hospital resources are stretched beyond the breaking point. There may be limited or no reimbursement from insurance companies for certain treatments, as well as limited bed availability for therapies that could easily be handled at home with the assistance of home care agencies, or placement in subacute rehabilitation or inpatient hospice settings to provide continued services.
With this in mind, Memorial Sloan Kettering Cancer Center (MSKCC) decided to expand into some outpatient areas that could have significant impact on admissions to the hospital.
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Tuesday, 19 May 2009 12:25 |
 Transformational Case Management
By Carol Cloud, RN-BC, BSN, CCM, Care Coordinator; Claudia Fox, RN-BC, MSN, Care Coordinator; Debby Jones, RN, MSN, Director, Case Management; and Linda Miller, RN, Care Coordinator; St. Mary's Medical Center
Ascension Health, our lead organization, recently challenged our hospitals to become “transformational,” encouraging our departments’ visions to be “moving to be the vision.” In December 2008, we initiated our Transformational Case Management Model. The model is developed through a combination of LEAN and Value Stream Analysis outcomes, evidence-based studies, our Journey to Excellence, and the Ascension Health Challenge.
We are increasing patient safety and satisfaction, decreasing length of stay appropriately, reducing duplication and nonvalue-added waste, engaging process improvement, raising the standard of performance, increasing staff motivation and shared governance, increasing staff accountability and collaboration, and, moreover, changing our practice paradigm from reactive to proactive case management.
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