Term
Case Management definition:
AKA: |
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a collaborative p0rocess designed to meet patient needs in a cost effective manner. (in and out, dischrge planning_
Discharge Planner |
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Focus is on population-based
Specific unit or alternate units
usually 10-25 patients |
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| Case management job description |
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| 3-5 years experience/God communication understand insurance and able to multitask |
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| Case management resposibilities |
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1. assesng clints ther home and communities
2. Coordinating and planning client care
3. colaboring with other health professionals
4. monitoring clients progress
5. Evaluating client outcomes |
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| Do you have to have a MSN to be a case manager? |
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Forms of patient care delivery systems
(common traditional care) |
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Total Patient Care
Functional Nursing
Team or Modular Nurisng |
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Oldest mode
Nurs assumse total responsibility
lines of responsibility are clear
primary nursing is form of total patient care (ICU, HOSPICE)
DISADVANTAGE: nurise is inadequately prepared leading to unsafe care; expensive |
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Everyone care for patients of a designated area/unit/wing have an assignment.
(ONLY MEDS, ONLY WOUNDS)
-economical, effeicient
-see in ORs long term care faciliteis
DISADVANTAGES:Fragmented
low job satisfaction
not cost effectif for patinet only for facility. |
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Originated to iprove funciona nursing (heirachy)
-charge nurse oversees teams are made up of team leader, nursing staff, patiens.
-may see an RN LPN and CNA caring for a group of patients
-DEMOCRATIC LEADERSHIP
-team shares resoponsibilty and accountability
DISADVANTAGES-
insufficient times leads toineffective communication regarding pland of care whci can lead to blurred lines of responsibilty errors and fragmentd care. |
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Management therories
MANAGMENT
LEADER |
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Management-coordinates process of leading and dircting with power/title
Leader-sets by example may not have a job title ehavior determindes leadership |
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ACCOUNTABILITY
AUTHORITY
RESPONSIBILTY |
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| the ability and willingess to assume responsibility for one's action and to accept the consequence of on'es behavior. Can cross many levels-individual, insitutional, professional, society (fall on RN shoulders) |
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| the righ to direct other and their activites. An integral part of manaing and conveyed through their actions. |
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| an oblgation to obtain objectives or perorm taks. Managers are responsible for utilization of resources, communication to seubordinates, and implementation or organization goals and objectives. |
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strong contorl
motivation by coercion
others are directed with commands
communication flows one direct-downward
decision making does not involve others
I and YOU instesad of we and us
criticism is punitive
High productiviy
Low creativity, self motivationand autonomy
useful in a crisis situation |
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Less control
Economic and ego rewardsare used to motivate
ohter are directed through suggestions and guidance
communication flows up and down
decision making involves others
we si used
criitsm is consturcive
promotes autonomy and growth |
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permissive with little or no control
motivates by supprt only when requested provids little or no direction
uses upward and downward communication
diperses decision making thouout the group
places emphasis on the gorup
does not riticize
can be frustraing
oftne have group disintrest
-not for control freak
-can work with small groups |
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| day to day operations, stes goals gives direction, reinforce with reward. |
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comitted to future, have vision gets people on board, turns followers into leaders.
(baptists survey gets people to participate) |
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| 21st centrury with leadership and managemet |
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servant leadership
prinipal agent theory
authentic leadership
emotional intellgence
quantum leadership
culteral bridgeing. |
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Change is ineveitale in anything
Nursing and healthcare are not invinciple to change |
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unfreezing
movement
refreezing |
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Assessment-identify the problem or opportunity that necessitaties change
Data collection and Analysis
Strategic determination-identifying possible solutions, barriers, strategies
Planning-establishing goals, wht who, how ,what and when of change
Implementiation-communication and conducting change
Evaluation |
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| Types of cahnge strateges |
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Power-coercive -Authority/threats to get complience
Normative-re-educative-social orientation, satisfactory relationships in workplace, peer presure
Rational-Empirical-Knowledge is power when little resistance is anticipated once workers understand, will be on board. |
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| people become aware of need for change either through convincing from a change agent or via guilt, anxiety or personal concern |
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| strategies are identified, planned out a implemented by the change agent; all the while, making sue driving forces outweigh restraig forces |
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| stabilizing the change occurs othtat it becomes the norm ususally takes months to be considerd "norm" by all stakeholders |
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driving forces-facilitators disire to please, raise, recognition
-restraining forces-fear of unknown, comfort with the norm
Resistance to change-how people respond to affects the whole process.
Leadership/manager role during change |
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| willing to change but not obsessed |
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| well everybody else is doing it-before average |
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| dont want change but do adapt |
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patients
triage
time management |
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Emergent-most acute
Urgent-acute
nonemergent-sparin ancle |
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| ANA refers to Delegation as: |
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| transfer of responsibility |
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1. Assess the workload
2. Analyze available staff-what good at
3.prepare assingments-based on nursing skills
4. communicating your expectations including deadlines
5. model the role and provide guidance
6.follow up and give feedback |
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Underdeligating-contrl freaks want hand in it, says dont turst subordentant
Overdelagaing-poor time management
Improper Delegating-5 rights of deligation |
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1. taks
2.circumstance
3.person
4.direction/communication
5. superivor/evaluation |
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vitals
accucheck
ambulate
no nurisng judgement can be used.
does not include assment and evaluation results be predictable and standard. |
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| tasks that cannot be delegated |
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Definition
any taks tha involves nursing judgment
initial assessments on new patients
assessing pain
teaching injections
evaluating success of treatments
interpreting test resultes
establishing plans of care
identifying needs
triage
counseling and treaching |
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