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Developed by the Case Management Society of America (CMSA), this manual provides case managers with the essential tools necessary to successfully support quality patient care within today's complex healthcare system. This updated and revised second edition addresses the role of the case manager and unpacks how to assess and treat patients with complex issues; including those who are challenged with medical and behavioural conditions and poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, and new performance measures, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach.
Written by case managers for case managers, this practical manual presents the CMSA--tested approach toward systematically integrating physical and mental health case management principles and assessment tools. As the healthcare field continues to increase in complexity and given the constantly changing regulatory environment, healthcare workers must know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice.
New to This Edition:
- Increased coverage and focus on Social Determinants of Health
- New chapters on support specialty populations including veterans, trauma survivors, maternal child health, children with special healthcare needs
- Simplified terminology and presentation of CMSA Assessment Grid and process
Key Features
- Aligned with the Model Care Act, the CMSA Standards of Practice, and the CMSA Core Curriculum for Case Management
- Assists case managers enhance their ability to work with complex patients and learn how to apply new evidence-based assessments, as it fosters safe and high-quality care
- Teaches case managers to evaluate patients for medical and mental health barriers in order to coordinate appropriate integrated interventions and treatment planning
- Integrates biological, psychological, social and health system assessment
- Supports care of adult, elderly, and pediatric patient populations with complex issues
SECTION I: THE ROLE OF INTEGRATED CASE MANAGEMENT IN ADDRESSING COMPLEXITY
Chapter 1: Defining Healthcare Complexity
Chapter 2: The Mechanics of an Integrated Case Management Approach
Chapter 3: The Interaction of Medical and Behavioral Conditions
SECTION II: STRATEGIES FOR PATIENT ENGAGEMENT AND RETENTION
Chapter 4: Communication Methods and Techniques
Chapter 5: Building Relationships
Chapter 6: Patient/Person-Centered Care
Chapter 7: Addressing Social Determinants
Chapter 8: Addressing Health Inequities
SECTION III: ADDRESSING COMPLEX PATIENT POPULATIONS USING AN INTEGRATED CASE MANAGEMENT APPROACH
Chapter 9: Common Physical and Mental Health Conditions
Chapter 10: Assessing the Adult Patient Through Application of the Integrated Case Management Complexity Assessment Grid
Chapter 11: Assessing the Pediatric Patient Using the Integrated Case Management Complexity Assessment Grid
Chapter 12: Targeted Care Planning and Care Transitions
SECTION IV: SPECIALTY POPULATIONS
Chapter 13: Trauma Survivors: Trauma Informed Care
Chapter 14: Children with Special Healthcare Needs
Chapter 15: Integrated Case Management for Veterans
Chapter 16: Maternal Child Health
SECTION V: INTERDISCIPLINARY TEAMS AND USING ICM TO IMPROVE OUTCOMES
Chapter 17: Composition, Roles, and Functions in Value-based Reimbursement Models
Chapter 18: The Integrated Case Management Complexity Assessment Grid as An Outcome Measure
APPENDICES
Appendix A: CMSA's Definition of Professional Case Management and the Standards of Professional Case Management Practice
Appendix B: Interdisciplinary Case Management Team
Appendix C: Triggers for Integrated Case Management Intervention
Appendix D: Integrated Case Management Complexity Assessment Grid (ICM-CAG)
Appendix E: Adult Integrated Case Management Complexity Grid Elements and Rating Scales
Appendix F: Pediatric Integrated Case Management Complexity Grid
Appendix G: Pediatric Integrated Case Management Complexity Grid Elements and Rating Scales
Appendix H: ICM-CAG Scoring Sheet
Appendix I: PIM-CAG Scoring Sheet
Appendix J: Definition of Terms
Appendix K: Abbreviations
Appendix L: Suggested Scripted Interview Questions
Appendix M: VA Affairs Integrated Case Management Standards of Practice
Appendix N: Emotional Intelligence Questionnaire