1.3 Different types of CM settings Flashcards
_____ diseases are characterized by rapid onset with a short duration
Acute
____ diseases require a lifetime of management, such as diabetes, lupus, heart failure and CKD
Chronic
Patients with multiple _____ are typically prescribed medication from multiple providers, leading to over medications or medication interactions.
comorbidities
Case managers should review all medications upon___, ___, ____
Opening a case, after each hospitalization, and after each visit to the doctor. (any change in status or level of care).
What are some options for patients struggling with medication costs?
- Medication samples from the doctor’s office
- Generic drugs when appropriate
- Co-pay assistance programs
- Disease-specific financial assistance
Poor adherence to the care regimen leads to:
- Decreased quality of life
- Higher healthcare costs
- Increased emergency dept visits
- Increased hospitalizations
- Avoidable nursing home admissions
- decreased productivity
- Poor clinical outcomes
- Premature death
_____ ______ is especially important for the long-term
management of chronic diseases, such as kidney disease, heart disease, and diabetes.
patient adherence
A patient’s ________ can be directly correlated to his understanding.
adherence
Especially when dealing with complex care regimens, client knowledge alone is not enough to
increase _________
Understanding the client’s beliefs, attitudes, support
system, and _______ will help the case manager communicatewith the client and foster collaboration.
adherence; self efficacy
For effective education:
- Use simple language; avoid medical jargon
- Limit instructions to 3-4 major points during each discussion
- Supplement teaching with written materials when appropriate
- Involve the client’s family or caregiver
- evaluate client understanding
- Reinforce concepts previously taught
_____ to medications takes many forms, including primarynonadherence, such as not filling the prescription, and secondary nonadherence, such as not
taking the prescription as prescribed (e.g., changing the dosage or frequency, stopping before completing the course of therapy, filling the prescription but never taking the medication,skipping or missing doses, or not refilling the prescription).
nonadherence
Reducing the ______ of pills or the _______ they are takencan also increase _____. The physician may be able to prescribe acombination medication and/or extended release medication to ______ the
_______ of pills taken.
number; frequency; adherence. decrease; number
As defined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO),_______ _______ is “the process ofcomparing a patient’s medication orders to all of the medications that the patient has been
taking,” to include name, dosage, route, and frequency.
Medication reconciliation
The goal of _________ ________ is todecrease adverse drug events by reducing medication errors, such as omission, duplication,drug interactions, and dosing errors. Most errors occur during patient _______
____ ____, including changes in setting, level of care, or practitioner.
medication reconciliation: transition in care
When Should Medication Reconciliation Occur?
- Anytime the patient is moved within the hospital, such as from the ICU to the step down unit
- Upon transfer to another facility
- Upon discharge from any facility
- At each doctor office visit
_______ of care can occur ____ _____ ______, such as when a patient is transferred from the ICU to the step downunit; __________, such as from a hospital to
a skilled nursing facility; and ________, fromthe primary care physician to the specialist.
Transitions; within a facility, between facilities; within the community
A ___________ patient is at increased risk for an ______outcome, due to medication errors, failure to follow up on testing or procedures, and/or not
continuing prescribed treatments or therapies.
transitioning; adverse
The CMS recommends providers issue a _______
for all transitions of care or referrals.
summary of care
The _________ matches ongoing needs of the
individuals being served by the case management process with the appropriate level and type
of health, medical, financial, legal, and psychosocial care for services within a setting or across
multiple settings.
continuum of care
A case manager’s role is to ensure _______
when a patient transitions through the continuum of care.
continuity of care
The ________ is agroup of healthcare professionals from various professional disciplines who work together to manage the physical, psychological, and spiritual needs of the patient. Whenever possible thepatient and the patient’s family should be part of the team.
Interdisciplinary Care Team (ITC)
When referring a patient to a healthcare provider, the case manager should make sure the
provider is ___________ to treat the patient.
professionally qualified
A _______ is a person, such as a doctor or nurse, or a corporation ororganization.
“provider”
_____ ______is a sub-specialty of casemanagement and other professions. It provides a comprehensive care plan for the healthneeds of an individual who has experienced a catastrophic injury or has chronic healthcare
needs.
Life care planning
A __________ completes a comprehensive
assessment, data analysis, and research to provide an organized and concise plan for the
present and future needs of an individual.
life care planner
