Authors: Suzanne K. Powell, Hussein A. Tahan
ISBN-13: 9780781790383, ISBN-10: 0781790387
Format: Paperback
Publisher: Lippincott Williams & Wilkins
Date Published: August 2009
Edition: 3rd Edition
Powell, Suzanne K., RN, BSN, CCM (Health Services Advisory Group, Inc., Phoenix)
Written for new case managers, this book is a practical guide for nurses, social workers, and others responsible for coordinating and managing the care of the individual patient within the healthcare system. It is also used as a text for graduate level courses and an excellent 'prep' guide for the Case Management Certification (CCM) exam. Suzanne Powell and Hussein Tahan are co-authors of the Case Management Society of America (CMSA) Core Curriculum for Case Management.
This Third Edition has new material on chronic disease management, information systems, and telehealth/telemedicine. New features include learning objectives and end-of-chapter study questions. CE credits are offered with this edition.
Reviewer:Tina M Snapp, BSN(University of Colorado Hospital)
Description:This is a book on comprehensive role definitions, explanations, and challenges affecting acute care facility case managers.
Purpose:The purpose is to describe the necessary tools needed to function in the world of managed care. Licensure, legal, and insurance issues are discussed. Historic and global information on case management and change implementation is included.
Audience:This book is directed at students and practicing case managers. It could also be used by physicians to help them understand the process of case management and enhance their understanding of regulatory requirements. All objectives are met by the author.
Features:A review of the essential elements of functioning as a facility case manager is provided. Legal issues pertaining to practice and reimbursement issues affecting discharge planning are well addressed. The author provides skills on how to navigate the managed care system and understand the decisions rendered by those organizations. Insurance issues are discussed in detail to to include reimbursement principles. Although the author touches on the ethical issues faced by case managers today, she could have included the position case and utilization managers are placed in to balance the reality of hospital financial issues and patient needs. It would have been beneficial to see the role of the payor case manager expanded and discussed.
Assessment:This book is better organized and more comprehensive that Powell's I)b>Advanced Case Management: Outcomes and Beyond (Lippincott Williams & Wilkins,2000). The book reviewed here contains resources for the beginner, intermediate, and even advanced case manager. Very good definitions and pertinent information to function in today's healthcare system are addressed. Overall, this is an excellent resource for nursing students, floor nurses, hopsital managers, utilization managers, and practicing case managers. Extensive information and detail in each category is provided. A large amount of interrelated information, pertinent to daily job responsibilities, is well organized.
Pt. I | Introduction to Case Management | |
1 | Overview of Case Management | 2 |
2 | Case Management Job Responsibilities and Essential Skills | 55 |
3 | Credentials, Organizations, Guidelines, and Standards | 95 |
Pt. II | Basic Concepts in Case Management | |
4 | Insurance | 128 |
5 | Utilization Management | 166 |
6 | Legal Issues in Case Management | 237 |
7 | Ethical Issues and Dilemmas | 296 |
8 | Quality Reviews and Risk Management | 328 |
Pt. III | The Case Management Process | |
9 | Discharge Planning: Understanding Levels of Care and Transfers | 354 |
10 | The Case Management Process | 410 |
Pt. IV | Practical Applications | |
11 | Job Stress Versus Success Factors in Case Management | 468 |
12 | Case Management by Proxy: Case Studies | 489 |
Glossary | 501 | |
Index | 511 |