Contact
Tracy Campos
Case Management Innovations
info@casemanagementinnovations.com
Case Management: The Fundamentals
Case Management 101: The Fundamentals is for case managers, charge nurses, house supervisors, or any nurse looking to expand their knowledge of case management. Case Management 101 is a one day educational event that will cover the fundamentals of case management from patient presentation to discharge. The national shift in healthcare today from a provider driven to patient centered system puts nurses at the center of this transformation. Case Management 101 will help equip you with the necessary knowledge to successfully make that transformation. Earn 10 CEU’s for attending the training session.
Learning Objectives:
1. Defne the roles and responsibilities of a rural hospital case manager.
2. Explain the process for determining and establishing the appropriate level of care at the different times of a an episode of care.
3. Define the role of the rural hospital case manager in managing utilization and reducing medically unnecessary care.
4. Define the case managers role is successfully transitioning the patient out of the hospital at the time of dishcarge.
5. Explain the various payers and the idiosyncrasies of payment and denial.
6. Define the important metrics that must be tracked and managed in order to maintain quality and control utilization.
7. Explain the concepts of managing physicians as important members of the quality and utilization management team.
8. Explore the tools available to a rural hospital case manager to successfully manage the role on a day to day basis.
About the Speaker
Dr. David Ficklen is the President and founder of Case Management Innovations. He obtained his Doctorate of Medicine from the University of Texas Medical Branch in Galveston and completed a residency in Internal Medicine at Wake Forest University. Dr. Ficklen has 15 years of practice experience in hospital and clinic settings. He served as Chief Medical Officer of a Texas Hospital where he developed a strong interest in developing case management programs. Additionally, Dr. Ficklen served as an Associate and Assistant Professor of Health at Sam Houston State University where he discovered a passion for educating. He has also served as the Chief Medical Officer an Emergency Department and Hospitalist Physician staffing company. In 2011, Dr. Ficklen started Case Management Innovations and has been dedicated to supporting smaller, rural hospitals in the areas of case management and utilization management. Dr. Ficklen’s experience as a practitioner, consultant, administrator and educator brings a unique perspective this exciting event.
SCHEDULE:
Session I: Utilization Focus in Case Management (CEU: 4.0)
8:30-9:00 - What is a rural hospital case manager?
Guided group discussion regarding the roles and responsibilities of a rural hospital case manager
9:00-10:00 - Utilization Management
Explore opportunities to reduce waste and medically unnecessary care
10:00-10:15 - Networking/Applying Utilization Management Discussion
Opportunity for attendee interaction and application of lessons
10:15-11:30 - Admission Status
In depth discussion regarding the level of care before, during and after a hospitalization
11:30-12:30 - RAC Audits
Review the CMS Recovery Audit program’s processes and procedures
NETWORKING LUNCH
Session II Efficient Operations in Case Management (CEU: 4.0)
1:00-1:30 - Managing Conflict
Working effectively with physicians to maintain quality and efficiency
1:30-2:30 - Transitioning Patients Out of the Hospital
Explain the best options of care for discharged patients to improve quality of care and reduce readmissions
2:30-2:45 - Networking/Applying Efficient Operation Principles
Opportunity for attendee interaction and application of lessons
2:45-3:45 - Important Metrics
Define the important metrics necessary for monitoring quality and utilization
3:45-4:45 - Managing the Day
Pointers for prioritizing the day for optimal efficiency
4:45-5:00 - Networking/Applying the Principles of Metrics and Time Management
Opportunity for attendee interaction and application of lessons
5:00 - Adjourn.
Session III Adjunct Tools for Case Management (CEU: 2.0)
(Web-based Course Work)
Legal Matters
Gaining familiarity with the legal aspects of patient care
Technology Solutions
Explore the possible technology solutions for case management more effective and efficient
Payers
Review the various payor sources and the idiosyncrasies for each
Testimonial:
"The benefit that the case management boot camp brought our facility was a better understanding among the nursing staff of the need for admission criteria to be met. It also helped to clarify the difference between the use of stay types such as Observation and Inpatient. Since the boot camp we have seen a reduction in the number of denials due to patient status being changed late in the stay due to misunderstanding of criteria. The nurses who participated in the boot camp were able to educate peers on the criteria and reasons for admission related to status to help control mistakes."
-Tashsa Kluck, Falls Hospital