The many purposes of this article is to understand the role and value of case management from the perspective of program directors, case managers and clients. A survey of program directors from publicly funded substance abuse treatment programs in Boston was administered, and in-depth interviews with a sample of program ...

Negative attitudes toward people who have serious mental illnesses held by mental health professionals threaten the effectiveness of psychiatric treatment. In this study, attitudes held by case managers working within the public sector were investigated. Differences between supportive and intensive case managers were compared with community controls using the Opinions ...

Quality management is the umbrella under which quality assurance, quality improvement, and peer review reside. Although quality assurance monitors structure, process, and outcomes, quality improvement strives to continually improve care. Ongoing communication among team members and utilization of ancillary resources facilitates an effective quality management program in obstetric (OB) triage. ...

To prepare case managers for the next millennium, Russell Coile, a noted healthcare futurist, and Pamela Matthews, a respected clinician and consultant, participate in a dialogue. Coile takes a broad view of millennial issues, while Matthews responds to those issues with her clinician's perspective. Case management will face challenges and ...

This article critically examines the definitions and component activities of case management in an effort to clarify and provide a better understanding of this phenomenon and to identify the areas that require further development for improving the knowledge base of this field. The approach is not meant to be exhaustive, ...

This article has attempted to gather up the evidence presented in the rest of this issue to give dentists a practical overview of the management of the carious process. The major points are that a caries risk assessment is not only logical, it is achievable; management of caries is by ...

Participants were 54 clients with serious psychiatric disorders and 21 clinical case managers. Clients' serious psychiatric disorders included Axis I diagnoses, such as schizophrenia and bipolar disorder. This study examined how attachment states of mind of both clients and case managers influenced the effectiveness of therapeutic relationships and client functioning. ...

Ear reconstruction is very difficult to perform and often results in a devastating deformity. The use of microsurgical replantation techniques has allowed very favorable aesthetic results. The authors report a case of partial ear replantation without venous repair with the use of medicinal leeches to decompress the acute venous congestion ...

Negative assumptions that people with dementia are at risk from a variety of dangers often influence the care they receive. Such attitudes are usually based on misunderstandings about the meaning behind observed behaviours. Good risk management practice involves assessing how risk can be managed in ways that enhance autonomy and ...

Clinical Risk Management and its integral elements form part of the foundation of 'Clinical Governance'. An important principle within Clinical Risk Management is that of consent and patient information which, in a changing climate of complaint and litigation, means that it is essential that clinicians have a sound understanding of ...

This is a personal experience in case management. The current surge of case management programs across the country has made a significant impact on the lives of many patients. But, does anyone ask, "What is the impact on those who are case managing?" As we share the struggles, griefs, and ...

OBJECTIVE: Clients with severe and persistent mental illnesses often require a representative payee to help manage benefit funds. This study compared the perceptions of clients and clinical case managers about the benefits of and problems with the representative payee relationship. METHODS: Fifty-four clients receiving assertive community treatment completed an interview ...

Peninsula Regional Medical Center in Salisbury, Maryland, sought to implement a case management program to reduce a rising number of denied claims for avoidable, nonacute-care inpatient days. Initial efforts focused on consolidating functions rather than monitoring and managing care, and denied claims continued to increase. A revised case management program ...

As the payer environment is carved into many segments, each with its own accountability relative to its financial liability, family members, providers, and even other case managers often find it difficult to comprehend the perspectives of the various parties represented. Indeed, one brain injury case I recently evaluated had four ...

Ergonomics can improve work quality, increase productivity, raise morale, reduce absenteeism, and reduce workers compensation. Laboratory managers are responsible for recognizing employees at risk of developing CTSs which represent 65 percent of all injuries reported. It is a wise investment to prevent injuries. It needs to be stressed to laboratorians ...

In response to the trend away from thinking of health care as a commodity to one in which quality is a differentiating feature among providers, primary care practices must focus on outcomes management. This article reviews the various clinical and office-based processes that influence practice outcomes. These include patient management, ...

/ This paper identifies lessons learned and issues raised during the development of an ecosystem monitoring strategy intended to support the Northwest Forest Plan. Adaptive ecosystem management, which requires monitoring as essential feedback to management, recognizes that action is necessary or appropriate, although knowledge may be imperfect. We suggest that ...

The culling decision is one of the most complex decisions in farm animal management. This article reviews concepts of culling, risk factors for cows to be culled, different culling policies and the present knowledge on how to develop an optimal culling policy. It is pointed out that there are major ...

Faced with a case-mix index they knew was too low for their facility, administrators at Vanderbilt University Hospital in Nashville, TN, set about formulating a new, integrated case management model stressing that case management is a process rather than a role. Under the new model, the hospital's old-fashioned utilization review ...

This study explores the different approaches to case management within, the Medicare Alzheimer's Disease Demonstration. Eight sites from around the country were selected to participate in a survey of case managers (N = 57) that evaluated their professional background and experience and how certain tasks, functions, and goals of case ...

Many case managers feel pressured by an increasingly competitive job market to take advantage of the recent proliferation in case management credentials and degree programs. And data suggest that credentialed and better-educated case managers can bring home significantly higher salaries. Even so, some experts are critical of the trend toward ...

OBJECTIVE: The patient who voices suicidal intent in terms of the future or in terms of certain life contingencies presents special difficulties for the therapist. The authors outline the challenges posed by this problem for assessment, clinical management, and risk management. METHOD: The authors examined and analyzed case examples from ...

The increased financial risk that not-for-profit integrated delivery systems have assumed to function under managed care has required them to become increasingly reliant on income and gains from their investment portfolios. This reliance underscores the need for these organizations to take steps to effectively manage their investment risk. Not-for-profit IDSs ...

The authors investigated the impact of provider characteristics on the performance of clinical case managers. Case managers in a large California county were interviewed using a structured instrument that assessed service linkage, assertive outreach, and family management. Findings indicate that assertive outreach was done more often by more experienced case ...

AIM: This paper is based on research into case management that aimed to evaluate the processes of the introduction of case management for elderly people into the community nursing services in Hong Kong. BACKGROUND: The Hospital Authority in Hong Kong introduced a pilot Case Management scheme into the Community Nursing ...

/ Emerging ecosystem science builds on adaptive management as an approach to dealing with salmon problems in the Pacific Northwest. Adaptive management brings scientific and democratic processes together. However, managers, the public, resource users, and scientists differ in their views on the causes of salmon decline. Managers emphasize habitat loss ...

This is the first of a series on how PHOs, IPAs, and other provider groups can manage a population of patients, particularly when involved in risk contracting. The first stories focus on the Medicaid population. Look in September's issue for stories about how to establish disease management guidelines for a ...

Notification about work hazards is a legal requirement in advanced industrial countries, but workers have claimed, that in many cases, they do not receive enough information regarding risks, exposure, and medical problems. The recent professional literature on the subject has explored the ways in which notification is delivered without sufficiently ...

Case management has been suggested as an innovative strategy which facilitates the linking of quality and cost-effective care. However, there is little consensus about what is actually being introduced under the name of case management. It is suggested that this absence of a clear understanding of case management has been ...

The roots of case management are more than a century deep. This innovative approach to managing, coordinating, expediting, and facilitating patient care is neither new nor exclusively limited to nursing practice. A review of the historic literature reveals that the evolution of case management is a byproduct of creative healthcare ...

Total quality management and continuous quality improvement have been advocated as management salvation and anecdotally have been linked to improvements in operational effectiveness. The Joint Commission on Accreditation of Healthcare Organizations has adopted quality management as the organization improvement measure of the future and has mandated its application. The article ...

Y2K raises challenges for healthcare risk managers that go beyond information technology issues. This article explains that (1) too little public attention is being paid to equipment which may well have Y2K faults and (2) few standards have been articulated for dealing with problems. Healthcare risk managers therefore must return ...

Focus groups were held with home care case managers in two cities in Canada which provided information on the role of the case manager, factors that influence decision making, recent changes that have taken place in case management, and the different and positive aspects of home care case management. Factors ...

Along with the restructuring and downsizing of healthcare organizations is the move toward further cost-reduction efforts, including the increased use of unlicensed assistive personnel for patient care activities. This can create new/increased risk exposures. Implications for healthcare risk managers are discussed and strategies for preventing and managing associated liability exposures ...

Employees in healthcare are exposed to numerous and varied risks that pose the threat of injury. Management of those exposures by the organization will ultimately help create a safe environment for staff, patients and the public. Incorporating workers' compensation into the risk management program is the first step toward managing ...

For your physician practice to be successful under a capitated contract, you must understand the subtleties of the arrangement that can impact the practice's level of risk exposure. This means you must know the key questions to ask when negotiating the contract and capitation amount, as well as what should ...

The purpose of this research, commissioned by an Area Agency on Aging in Pennsylvania, is to identify the factors that impact on the process of case management in urban and suburban settings. Random samples of clients receiving the same service in an urban and a suburban area were compared as ...

Most medical schools and postgraduate residency programs do not focus adequate attention on risk management and quality management issues. This article will prepare physicians with an adequate working knowledge of risk management and quality management information, which will enable them to practice more effectively in today's litigious and regulatory climate.

Until a few years ago, the triennial JCAHO survey only peripherally involved the risk manager. With the advent of the sentinel event policy, this will certainly change regardless of whether the organization chooses to self-report. It is anticipated that the risk manager will be involved with the triennial survey particularly ...

Case management is a worldwide phenomenon and depending on the particular country's organizational framework of the health and social system, many models have been developed. The definitions of case management vary, but all of the models being developed aim to provide holistic quality care that is cost-effective. Reviewing the various ...

Risk managers already deal with a great many issues in today's complex, managed-care driven, healthcare environment. Now they must add expertise in handling ever more complicated employment issues. This article addresses areas risk managers need to both know and understand concerning this area of law, and some steps they can ...

The era of managed care medicine has brought with it new and interesting legal risks. This article presents the physician with an introduction to managed care and risk management. Medical malpractice, as it involves managed care organizations, is introduced, and several risk management strategies are developed to help the practicing ...

Although risk management is an industry that came into vogue 20 years ago because of a malpractice crisis, it has evolved beyond the singular concern of professional liability. That's evidenced by the entries for the seventh annual Excellence in Healthcare Risk Management Award competition. Each of this year's winners put ...

A great deal of discussion and research has gone into defining and clarifying the role of "case manager" (CM) for persons with severe mental illness. This three state survey examines the philosophy and activities of practicing CMs in an attempt to identify current styles of case management. A cluster analysis ...

For case management, information-based practice is not only important but mandatory in the current competitive healthcare settings that require "cutting-edge" knowledge of clinical research, business administration, managed care principles, and quality and cost-effective standards of practice. Obtaining case management-related electronic information through the Internet and CD-ROM computer databases can provide ...

There's danger in direct contracting with employers, but big advantages if you know how to steer clear. In this excerpt from Dealing Direct, a recent book from American Hospital Publishing, the authors point out common obstacles--from retaliation by insurers to managing high-risk enrollees to shifts in the market.

There are currently no scientifically defined critical management points or critical control points to manage foodborne pathogens at the pre-harvest level. Research is ongoing: much of the pre-harvest research is funded by producer organisations. The beef industry has Beef Quality Assurance (BQA) programmes in place and these are dynamic. Groups ...

As case management programs seek to demonstrate effectiveness data are needed on the interventions used by case managers. This research was done to quantify the interventions used by case managers for low-income prenatal clients. Using the Client Intervention Form, case managers from two local health departments, whose caseload included pregnant ...

Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect ...

Modern cities depend on individualism and the process of contracting. Contracts between individuals contribute to stability and order in cities. However, this is challenged by risks and uncertainties especially those relating to vulnerable individuals who are unable or unwilling to enter into contractual relations. This paper focuses on the role ...