Developed by the Case Management Society of America (CMSA), this manual provides case managers with the essential tools necessary to successfully support quality patient care within todays complex healthcare system. This updated and revised second edition addresses the role of the case manager and unpacks how to assess and treat patients with complex issues; including those who are challenged with medical and behavioural conditions and poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, and new performance measures, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach.Written by case managers for case managers, this practical manual presents the CMSA--tested approach toward systematically integrating physical and mental health case management principles and assessment tools. As the healthcare field continues to increase in complexity and given the constantly changing regulatory environment, healthcare workers must know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. New to This Edition: Increased coverage and focus on Social Determinants of Health New chapters on support specialty populations including veterans, trauma survivors, maternal child health, children with special healthcare needs Simplified terminology and presentation of CMSA Assessment Grid and process Key Features Aligned with the Model Care Act, the CMSA Standards of Practice, and the CMSA Core Curriculum for Case Management Assists case managers enhance their ability to work with complex patients and learn how to apply new evidence-based assessments, as it fosters safe and high-quality care Teaches case managers to evaluate patients for medical and mental health barriers in order to coordinate appropriate integrated interventions and treatment planning Integrates biological, psychological, social and health system assessment Supports care of adult, elderly, and pediatric patient populations with complex issues
Rebecca Perez, MSN, RN, CCM, FCM is an experienced Registered Nurse with a masters degree in nursing, is a Certified Case Manager, a member of the Omega Gamma Chapter of Sigma Theta Tau International Nursing Honor Society, Capella University National Society of Leadership and Success, and a member of the National Quality Forum Leadership Consortium. Her most recent works are primary author for Case Management Society of America Integrated Case Management: A manual for Case Managers by Case Managers, Second Edition, CMSAs Case Management Adherence Guide 2020, CMSAs Case Management Adherence and Transition of Care Guide for Clostridiodes difficile, and CMSAs Case Management Adherence and Transitions of Care Guide for Hepatic Encephalopathy. She is the author of numerous professional articles and resources for CMSA, and speaker on case management topics. She is the Senior Manager of Education for CMSA and Executive Director for the Case Management Society Foundation. She was recently awarded a Fellow in Case Management designation.
SECTION I: THE ROLE OF INTEGRATED CASE MANAGEMENT IN ADDRESSING COMPLEXITYChapter 1: Defining Healthcare Complexity Chapter 2: The Mechanics of an Integrated Case Management Approach Chapter 3: The Interaction of Medical and Behavioral Conditions SECTION II: STRATEGIES FOR PATIENT ENGAGEMENT AND RETENTION Chapter 4: Communication Methods and Techniques Chapter 5: Building Relationships Chapter 6: Patient/Person-Centered Care Chapter 7: Addressing Social Determinants Chapter 8: Addressing Health Inequities SECTION III: ADDRESSING COMPLEX PATIENT POPULATIONS USING AN INTEGRATED CASE MANAGEMENT APPROACH Chapter 9: Common Physical and Mental Health Conditions Chapter 10: Assessing the Adult Patient Through Application of the Integrated Case Management Complexity Assessment Grid Chapter 11: Assessing the Pediatric Patient Using the Integrated Case Management Complexity Assessment Grid Chapter 12: Targeted Care Planning and Care Transitions SECTION IV: SPECIALTY POPULATIONS Chapter 13: Trauma Survivors: Trauma Informed Care Chapter 14: Children with Special Healthcare Needs Chapter 15: Integrated Case Management for Veterans Chapter 16: Maternal Child Health SECTION V: INTERDISCIPLINARY TEAMS AND USING ICM TO IMPROVE OUTCOMES Chapter 17: Composition, Roles, and Functions in Value-based Reimbursement Models Chapter 18: The Integrated Case Management Complexity Assessment Grid as An Outcome Measure APPENDICES Appendix A: CMSAs Definition of Professional Case Management and the Standards of Professional Case Management Practice Appendix B: Interdisciplinary Case Management Team Appendix C: Triggers for Integrated Case Management Intervention Appendix D: Integrated Case Management Complexity Assessment Grid (ICM-CAG) Appendix E: Adult Integrated Case Management Complexity Grid Elements and Rating Scales Appendix F: Pediatric Integrated Case Management Complexity Grid Appendix G: Pediatric Integrated Case Management Complexity Grid Elements and Rating Scales Appendix H: ICM-CAG Scoring Sheet Appendix I: PIM-CAG Scoring Sheet Appendix J: Definition of Terms Appendix K: Abbreviations Appendix L: Suggested Scripted Interview Questions Appendix M: VA Affairs Integrated Case Management Standards of Practice Appendix N: Emotional Intelligence Questionnaire