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.


Questions and Answers
  • 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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