This webinar will focus on the three components most needed by the case management leader.These include the structure, processes and outcomes of the department.We will start with a discussion of the best practice structural elements of a contemporary case management department including roles, functions, models and staffing ratios. We will then talk about how to be sure your processes are hard wired and that your staff and your department are functioning in a compliant way.Compliance includes the federal rules, local and hospital requirements and should be updated on an annual basis. We will review the Conditions of Participation for both utilization review and discharge planning. We will review ways in which to audit your staff’s documentation to ensure compliance at all points. We will also discuss the important of ongoing monitoring and managing of your department’s case management outcomes to be sure that the department is moving in a positive direction.Case management report cards are a great way to organize and monitor your outcomes on a consistent basis. They can also be used as a foundation for your utilization review committee, a requirement of the Conditions of Participation from CMS.Report cards can also help you in determining that you have the right number of staff based on the productivity of the department. All this, and more, will be discussed in this jam-packed two-part webinar!
Whether you are a new case management leader or a seasoned one, it is always important to stay current and up to date on the knowledge and skills you need to remain at the top of your game. The role of the case management leader in the acute care setting is one of the hardest jobs in the hospital. It requires that you maintain a combination of skills, including clinical, financial and leadership. You must understand best practices for all the roles performed by your staff. Finally, you must be sure you consistently review your department’s outcomes to ensure that your department is meeting its goals and objectives.
Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, providing on-site education to case management staff, and strategies for assisting health care organizations in improving their case management department’s efficiency and effectiveness.
The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.
Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.
Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore – Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.
Dr. Cesta has presented topics on case management at national and international conferences and workshops. Her books include “Nursing Case Management: From Essentials to Advanced Practice Applications”, “The Case Manager’s Survival Guide: Winning Strategies in the New Healthcare Environment”, “The Case Manager’s Survival Guide: Winning Strategies for Clinical Practice”, “Survival Strategies for Nurses in Managed Care” and “Core Skills for Hospital Case Managers”.