Case management models in the acute care setting are constantly evolving and improving. So is true for case management in the emergency department. RN and Social Work case managers working in this fast-paced setting must evaluate patients who will be treated and released, those being placed into observation and those being admitted to an inpatient bed. Therefore it is imperative that the ED case management model is consistent with the inpatient model but yet applied differently in order to address these categories of patients.
The ED case management professional must learn how to “triage” large numbers of patients, many of whom may need a case management intervention. In addition, EMTALA (The Emergency Medical Treatment and Active Labor Act) guidelines and rules must be obeyed and the Value-Based Reimbursement metrics must be taken into account.
Whether you work in the ED or not, you need to understand this important and critical role as it interfaces with every other case management professional in the acute care setting. We will discuss the structure of a best-practice ED case management model as well, and the processes the roles should follow. We will conclude with outcome measures for ensuring that your ED program is making a difference for your organization.
- Understand the changing role of the ED RN case manager
- Discuss the role of the social work ED case manager and how to identify social determinants of health
- Review ways in which to “triage” patients in the ED from a case management perspective
- Describe EMTALA and how it is applied
- Evaluate the Value-Based Reimbursement metrics most greatly affected by ED case management
- Apply the case management roles to the ED setting
- Discuss ways in which to measure the outcomes of an ED case management model
Areas Covered in the Session:
- Role of the social worker in the ED including social determinants of health
- Role of the RN Case Manager in the ED
- Interfacing the ED case managers with the in-patient units
- Value-Based metrics in the ED
- How to prioritize (triage) ED patients from a case management perspective
- Applying best-practice case management roles in the ED
- ED case management outcomes
- Live Q&A session
- Director of Case Management
- Director of Compliance
- Case Managers
- Social Workers
- Vice President of Case Management
- Directors of Patient Centered Medical Homes
- Home Care Directors and Managers
- Home Care Case Managers
- Community-Based Providers
- Directors of Nursing
- Directors of Ambulatory Programs
- Directors of Quality
- Directors of Finance
About the Presenter:
Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, provides education on case management and related topics, and on-site assistance to case management departments.
The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.
Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.
Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore-Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.
You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.
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Headset: Any decent headset and microphone which can be used to talk and hear clearly
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