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Test 3: Case Management Questions with Accurate Answers
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referrals to local organizations, this is not a goal of case management. (3) CORRECT: One of the primary goals of case management is to reduce fragmentation of care. (4) Although case managers help to make discharges more efficient, this is not a goal of case management. A nurse applied for a case manager position at the local hospital because the job description of the case manager is to: A ) Help clients determine the best care for the least cost. B ) Eliminate the competition from other providers. C ) Provide a service that costs very little to offer. D ) Decide what treatment will be provided. correct answer A Hospital needed a mechanism to find high-quality, cost-effective care to meet client needs. Case managers can assist the hospital and the clients to reduce the costs of care and ensure that a high quality of care will be provided. Case management goals: correct answer Decrease fragmented/duplicated care, enhance quality cost effective outcomes, patient center/goal oriented plan of care, coordinated care, identify at risk patients. WILL decrease LOS. Case management philosophy: correct answer Achievement of client wellness & autonomy through advocacy, communication, education, identification of resources and services. All done in a timely and cost efficient manner.
A) Is not appropriate because a diagnosis of a terminal condition has been made. B) Begins when the order is written to begin chemotherapy. C) Begins when the client receives the diagnosis of cancer. D) Ends when the client is discharged to a home health service. correct answer C The case manager should be involved from the time that admission of the client and the process of case management are implemented, shortly after the diagnosis has been made. This ensures that multiple services are provided in an efficient and cost-effective manner. Maintaining quality while streamlining cost: correct answer Increased quality of care will decrease the length of stay, adverse outcome rate and waste therefore cost. Multi-disciplinary team correct answer A team in which health and care workers from different professional backgrounds and with different work roles, plan, implement and monitor and individual's care. Patient navigator/advocate correct answer A person who identifies patients' needs and barriers and assists by coordinating care and identifying community and healthcare resources to meet the needs. Role of Case Manager correct answer Care team manager, coordinate patient care/continuum of care, providing assessment, multidisciplinary team, plan of care, reassessment and evaluation, coordinates with
insurance/payers, evaluates interventions, advocates, teachers, change agent,Develops policies, discharge planning, quality care of you, legal ethical issues addressed, documentation Roles in the multidisciplinary team: correct answer Administration (Resources available), providers (tests, procedures), payer, regulatory bodies, discharge (rehab, long-term care, contracts), and #1 the patient The influence of case managment into hospitals was from? correct answer Implementation of diagnosis related groups reimbursment from Medicare The nurse is coordinating a case management system of care for which of the following purposes? Select all that apply: A Matches the intensity of the services B Coordinates designated components of health care C Assists the client with method of payment D Provides continuity of services E Avoids fragmented services F Encourages the client to direct the decision making of the care correct answer A,B,D&E Case management is a type of delivery of care in which the health care needs of the client are managed by a nurse or physician. The purpose of case management is to ensure continuity of care and avoid fragmented services. It also coordinates all designated components of health care