Case Management & Discharge
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The clinical case manager has a leading role in safe effective patient discharges to the appropriate level of care, while taking into considering cost effectiveness, quality and safety, and evidenced-based patient outcomes, while adhering to regulatory requirements.
- 1.The case management assessment should be completed:
- A.
Within 24 hours to 48 hours.
- B.
As soon as convenient, just as long there is documentation in the chart.
- C.
- D.
Up to 72 hours.
- 2.The discharge assessment usually indicates the expected level of care the patient will require upon discharge. This assessment should be done:
- A.
Simultaneously with the admission assessment.
- B.
Within 24 hours.
- C.
Within 24 hours and update throughout the hospital stay.
- D.
Only if there is a firm discharge plan identified.
- 3.An in depth case management assessment is basic to understanding the patient's previous and current response to treatment and how effective (or not ) the utilization of services are meeting the patient's needs.
- A.
True
- B.
False
- 4.Discharge rounds are essential to collaboration among the healthcare team and sharing of informatin of the patient's response to the treatment plan. It should include all of the following:
- A.
Physical, mental, behavioral status
- B.
Family gossip
- C.
The patient progressing/responding to treatment plan
- D.
Should reflect an interdisciplinary approach
- E.
Should never be documented, because it was a verbal interchange.
- F.
Discuss discharge readiness and appropriate level of care (ICU, SDU, RNF)
- 5.The case manager looks for previous admissions and completes the readmission assessment only on patients that returned within 30 days to the same hospital.
- A.
True
- B.
False
- 6.In the last 5 years, only 20% of the U.S, population used 80% of the total healthcare spending of $2.9 trillion dollars by some estimates. Forty-percent of hospitalized patients return within 30 days of discharge and cost Medicare an estimated $17.4 billion dollars An effective case management program aids in reducing readmission rates.
- A.
True
- B.
False
- 7.Case scenario: the case manager reviews a post-operative patient chart and finds that anti-coagulation is not ordered. Also, there is a completed PT evaluation, the OT evaluation was ordered but not seen in the chart. The patient has a commercial insurance product. What should he/she consider?
- A.
Leave a note on the chart for the physician to address the anti-coagulation requirement of SCHIP/post-op patients.
- B.
Page the OT on duty to find out when the evaluation will occur.
- C.
Wait for the PT therapist to tell the OT therapist.
- D.
Ask the hospital's Utilization Department to arrange for a skilled nursing facility precertification.
- 8.The case manger proactively evaluates patients at risk of readmission, or in need of post-acute referrals. A critical review of the following is taken into consideration: the medical history, medications taken, re hospitalizations consultant evaluations, test/procedure results, and input from the patient/family.
- A.
True
- B.
False
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