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DFW Case Notes
July 2010
 
President's Message
Cathy Campbell, RN-BSN, CHC, MBA, FACHE

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The summer is keeping with the usual trend, Hot Days. Hope all enjoyed the 4th of July holiday commemorating the founding of this great country. I wish many of you could have been at the annual CMSA National Conference. We had an exciting time learning updates in healthcare, internet social networking, and various specific working arenas, e.g. managed care. The leadership sessions were beneficial to the attendees. They provided a great evening at downtown Hollywood with dinner, dancing, and free rides. Some of us just watched those riding the rollercoaster and other fast scary rides.

Often we feel that our practice as Case Managers has been a trial and error process. Through the years our practice has been well developed by experts in practice. Introduced and implemented processes have developed through organizations working closely with CMSA. To mention a few organizations, NNTOC, URAC, and CMAG. Our once unpaved path is now filled with evidenced-base practice. Our credibility and value continues to be tested as we continue to show our viability and importance in the healthcare arena. I strongly believe in the presence of Case Managers at all levels of care and transition returning to the independent quality of life once secured.

We were introduced to the advantages of social networking available through the internet. Linkedin, Facebook, and Twitter are just to name a few. These are free networking sites allowing introduction and discussion how others are dealing with difficult situations and resources for quality patient care transitions. I believe it will be well worth your time to review these available networks, as well as the networking available with Communities of Practice on our National CMSA site.

Mark you Calendars:
7/21-22/10 Waco-'On the Road'
9/21/10 First Dinner Meeting
10/10/10 Case Management Week
10/19/10 Prep Class / Dinner Meeting
10/20/10 Fall Seminar
11/16/10 Dinner Meeting
12/14/10 Dinner Meeting

Watch for the announcement of the new Web DFW CMSA Web-site

Notes from the President Elect
Kathy Kucera, PhD, RN, CCM

Kathy Kucera

Standards of Practice for Case Management Review Part 3

The 2010 Standards of Practice for Case Management (SOP) identify the following components in the case management (CM) process:

  • Client Identification and Selection
  • Assessment and Problem/Opportunity Identification
  • Development of the CM Plan
  • Implementation and Coordination of Care Activities
  • Evaluation of the CM Pln and Follow-Up
  • Termination of the CM Process

These components in the CM process do not differ a great deal from the six Standards of Care identified in the 2002 Standards of Practice. However, the steps listed in the above CM process are not intended to be linear nor a one-way exercise. For example, the assessment responsibilities will occur at all points in the process, and functions such as facilitation, coordination, and collaboration will occur throughout the client's health care encounter.

The CM process is carried out using critical-thinking and evidence-based knowledge. It is not the intent of the 2010 SOP to parallel key responsibilities of CM, but rather to broadly define major functions involved in the CM process to achieve desired outcomes.

One of the biggest changes in the 2010 SOP is how each Standard is to be demonstrated by the case manager. In the 2002 SOP each of the six Standards of Care was followed by a Measurement Guideline which the case manager would "seek" to accomplish. However, in the 2010 revision, each of the 15 Standards of CM Practice is followed by specific documentation or actions needed to "demonstrate" that the Standard was met by the case manager.

Below is a brief review of the first four Standards of CM Practice. In this column I can only give a partial listing of how each Standard of CM is to be demonstrated. I would encourage each of you to take the time to look more closely at this important refinement of the 2010 SOP.

Standards of Case Management Practice

A. Client Selection Process for CM The case manager should identify and select clients who can most benefit from case management services available in a particular practice setting. Demonstrated By:

  • Documentation of consistent use of the selection process within the individual organization's policies and procedures.
  • Use of high-risk screening criteria to assess for inclusion in CM programs (i.e. poor pain control; repeated emergency department visits; repeated admissions; poor nutritional status; financial issues).

B. Client Assessment
The case manager should complete a health and psychosocial assessment, taking into account the cultural and linguistic needs of each client. Demonstrated By:
 

  • Documentation of client assessment using standardized tools, when appropriate, as pertinent to the CM's practice setting (i.e. client strengths and abilities; health status expectations and goals; transitional or discharge plan; advance care planning; health literacy and illiteracy; readiness to change).
  • Documentation of resource utilization and cost management; current diagnosis(es); goals (short and long term); provider options; and available health care benefits.
  • Evidence of use of relevant, comprehensive information and data required for client assessment from many sources (i.e. client interviews; family, providers, other members of the interdisciplinary health care team; data, claims and/or adminstrative).

C. Problem/Opportunity Identification
The case manager should identify problems or opportunities that would benefit from case management intervention. Demonstrated By:
 

  • Documentation of agreement among the client, caregiver and other providers and organizations regarding the problems/opportunities identified.
  • Documented identification of opportunities for intervention (i.e. non-adherence to plan of care; lack of education or understanding; inappropriate discharge or delay from other levels of care; frequent transitions between settings).

D. Planning
The case manager should identify immediate, short-term, long-term, and ongoing needs, as well as develop appropriate and necessary case management strategies and goals to address those needs. Demonstrated By:

  • Documentation of relevent, comprehensive information and data using interviews, research, and other methods needed to develop a plan of care.
  • Validation that the plan of care is consistent with evidence-based practice, when such guidelines are available and applicable.
  • Documentation of client's or client's support system participation in the written case management plan of car; documentation of agreement with plan, including agreement with any changes or additions.
  • Facilitation of problem-solving and conflict resolution.
  • Evident of supplying the client with information and resources necessary to make informed decisions.
  • Compliance with payer expectations with respect to how often to contact and reevaluate the client or redefine long or short term goals.

To Be Continued.

kkucera1@tx.rr.com

 

From My Corner...
BK Kizziar, Executive Director

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BIG NEWS!!

Don't forget that the Chapter website is changing August 1st. The new website will be dfwcmsa.org. The "org" is what is changing. The new site has been enhanced and offers a lot of new information that easily accessible. One new feature is the "Members Only" section. DFW CMSA members will have access to Chapter information, Bylaws, policies and procedures, Board meeting information and much more. And our meeting planner, Micki Johnson, has asked me to remind everyone NOT to put us in your "Favorites" as it doesn't always update to our newest information and your registration for the dinner meetings may not go through.

Waco! Here we come!

The Strategic Planning Committee is hosting a "Takin' It On The Road" seminar in Waco on July 21 & 22. The first day will be a CCM Prep Class with the second day featuring a full day dedicated to hospital case management topics, ethics and professional development. Last year's "On the Road" seminar in Tyler was very successful and we anticipate Waco will be as well. If you or any of your peers are interested in learning more about this great CEU opportunity, check out the current website for details (dfwcmsa.com).

Gearing Up For Fall

September will see the return of our monthly dinner meetings. Remember that our meetings run from September through May, are on the third (3rd) Tuesday of each month and held at the Grapevine Convention Center. We are planning some exciting new details regarding dinner meeting registrations so stay tuned for the August newsletter. Here are some things that haven't changed:
· Dinner meeting reservations are required and must be made prior to 5pm on the Friday before the meeting.
· Reservations received after 5pm on Friday will be charged an additional $3 late registration fee. The reason for this is that the convention center requires us to tell them how many meals to prepare by Monday. Add-ons are an extra charge for the Chapter.
· If you know that you will not be able to attend and have a reservation, it must be cancelled no later than noon the day of the meeting to prevent being charged for the dinner meeting plus a $3 non-cancellation fee. The meal has already been ordered, prepared and the Chapter billed. The $3 fee is a processing fee for the invoices sent to those who do not cancel.
· Everyone admits that the food at Grapevine is very good. So good, in fact, that we often run out of food. And occasionally, in the excitement of having fajitas or their famous fried chicken, people take more than one plate at a time. The convention center puts out exactly the number of plates for the number of dinners ordered. The Chapter is charged for a meal for every additional plate that is requested. Please keep this in mind when tempted to pick up that second plate for chips and salsa or more chicken.
· Highway 114 will be under construction during most of this upcoming Chapter year. While the convention center is only 1.2 miles further west than the hotel where we use to meet, traffic is everyone's concern. For those of you traveling west on Hwy 114 there is a "back way" that you might consider. And there's also one for those of you coming off the 121 Toll Road. This will keep you away from the 114/121 merge where things get so bad.

From Hwy 114:

  1. Exit Freeport Parkway and go north (right)
  2. Get on LBJ west but stay in the far right lane
  3. You must exit on Bass Pro Drive
  4. Turn left on Bass Pro Drive
  5. Turn left on Northwest Highway (Hwy 26)
  6. Turn left on Main Street
  7. Turn left on Vine
  8. The convention center is dead ahead

From 121 Toll Road

  1. Exit 121 onto Bass Pro Drive
  2. Turn right on Bass Pro Drive
  3. Turn left on Northwest Highway (Hwy 26)
  4. Turn left on Main Street
  5. Turn left on Vine
  6. The convention center is dead ahead

The Members

The members of this Chapter are the most important and valuable people to this organization. It is the members who faithfully attend the dinner meetings and other Chapter events that make this Chapter one of the largest of the 73 CMSA chapters in the country and one of the strongest. It is the members who drive the officers and board members to do their best to meet member needs and provide productive networking and quality educational opportunities. It is the members who we serve.

In order to do that as effectively as possible, every evaluation and comment is taken seriously. Every recommendation is considered. And your feedback is the most valuable tool we have in developing programs and creating opportunities for our members. We need your feedback in order to give you what you want and need. And my promise to you is that any communication that I receive will get a response. And all recommendations are taken before the board for discussion and consideration.

Some things can be readily changed, some require planning and some are not within our ability to change. Some have financial implications. But all communications are welcome and will receive a response. Please. Let me hear from you. How can we make your Chapter experience better?

bkandassoc@verizon.net

 

Membership Update
Julie Carroll, LMSW, CCM

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New members:
Tom Emanuele, Dallas
Carmencita Esteve, Austin
Patrick Henry, Duncanville

Welcome to our new members above!!! As membership secretary, I am excited to see a new promotion through Linkin for a 20% discount if you are a Linkin member. Please click on Linkin Member's Discount to download the promotional flyer.

Remember to visit our website at www.dfwcmsa.com or the national website at www.cmsa.org to learn more about the many benefits of membership. We have our newsletter, magazine publications, conferences and dinner meetings to attend. Networking is such an integral part of these events as you meet other professionals.

Thanks so much for being a member of DFW CMSA and contact me for any member needs --- carrolljulie@sbcglobal.net.