746 results match your criteria Professional Case Management [Journal]


Case Management Dementia Care: United Kingdom and Europe.

Authors:
Phil Harper

Prof Case Manag 2019 May/Jun;24(3):167-172

Phil Harper, PGDip, is currently an associate lecturer at the University of Worcester and a doctoral candidate at Manchester Metropolitan University exploring care staff's understanding of the needs of an LGBTQ+ persons living with dementia. He has worked in dementia care for 7 years; previously, he worked in hospitals, charitable organizations, and most recently care homes. Mr. Harper holds a bachelor's degree in Health Science from the University of Worcester and a postgraduate diploma in practice development in dementia care from University of Cumbria. He has been involved in the development of dementia training for hospitals and care homes.

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http://dx.doi.org/10.1097/NCM.0000000000000366DOI Listing

Understanding Spirituality and Faith Practices: Advocating for the Whole Person.

Authors:
Jeannie LeDoux

Prof Case Manag 2019 May/Jun;24(3):165-166

Jeannie LeDoux, BSN, MBA, RN, CCM, CPHQ, CTT+, is chair of the Commission for Case Manager Certification, the first and largest nationally accredited organization that certifies more than 45,000 professional case managers and more than 2,600 disability management specialists. She is also a Senior Clinical Educator at MCG, part of Hearst Health. Her professional work includes work with diverse cultures and with special needs and complex medical issues. She also has extensive experience working with the military.

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http://dx.doi.org/10.1097/NCM.0000000000000365DOI Listing

Duty to Warn 4.0.

Prof Case Manag 2019 May/Jun;24(3):160-164

Lynn S. Muller, JD, BA-HCM, RN, CCM, is a nurse-attorney and independent professional case manager. Dr. Muller is an adjunct professor in the MSN and DNP programs at Saint Peter's University of New Jersey where she received her bachelor's degree in Healthcare Management. Dr. Muller is the Contributing Editor of the Professional Case Management journal, the official journal of CMSA, and has authored more than 50 articles and the legal chapters of the fourth edition of Case Management: A Practical Guide for Education and Practice, the legal chapter the third edition of the CMSA Core Curriculum for Case Management, and the Legal and Ethical Issues Chapter of Leadership & Nursing Care Management (6th Ed.). Dr. Muller is a contributor to the CMSA Career & Knowledge Pathways Project and Standards of Practice for Case Management. She is also a contributor for the CCMC Case Management Body of Knowledge (CMBOK) and a former commissioner of CCMC, where she now serves on the Professional Development and Education Subcommittee and as a Facilitator for the CCMC Certification 360 Immersion Training. Dr. Muller is a past president of the NJ Chapter of CMSA and a former member of the Board of Directors of CMSA of New York City. Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, is Principal, EFS Supervision Strategies, LLC, is an award-winning industry thought leader who empowers health care's transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. Known as "The Ethical Compass of Professional Case Management," Ellen is an esteemed author with more than 100 publications to her credit. She has developed content for many of the industry's knowledge projects for case managers, including books, chapters, articles, and continuing education on the Ethical Use of Technology, Competency-Based Case Management, Collaborative Care, the Social Determinants of Health, and the various dimensions of Workplace Bullying. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations, including roles as subject matter expert, examination item writer, and leadership positions. She is a vibrant professional voice.

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http://dx.doi.org/10.1097/NCM.0000000000000364DOI Listing
April 2019
2 Reads

Improvisation and Client-Centered Professional Case Management.

Authors:
Teresa M Treiger

Prof Case Manag 2019 May/Jun;24(3):158-159

Teresa M. Treiger, RN-BC, MA, CCM, CHCQM, FABQAURP is a past president of CMSA and current director on the National Transitions of Care Coalition. She is Principal of Ascent Care Management, LLC, Quincy, MA, specializing in private client case management, education, program design, and writing. Her health care career has spanned across the continuum. She designed and implemented case management, transition of care, frequent emergency department utilization, and uncompensated care programs while at McKesson. Her clinical experience includes acute and rehabilitation care.

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http://dx.doi.org/10.1097/NCM.0000000000000363DOI Listing

Case Managers a Catalyst for Patient Activation.

Prof Case Manag 2019 May/Jun;24(3):155-157

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http://dx.doi.org/10.1097/NCM.0000000000000362DOI Listing

Integration of the National Comprehensive Cancer Network (NCCN) Distress Screening Tool as a Guidepost for Telephonic Oncology Case Management.

Prof Case Manag 2019 May/Jun;24(3):148-154

Alysia Jean Swanson, BSOM, RN, CCM, leads Clinical Program Development and clinical oversight of Cigna's Oncology Case Management program as Clinical Program Development Manager at Cigna. A certified case manager and Six Sigma Green Belt, she serves as a board member for the Oncology Nurse Society of Chattanooga Tennessee. Liana DesHarnais Castel, PhD, MSPH, is Editor-in-Chief of Patient Related Outcome Measures (Dove Medical Press, part of Taylor & Francis Group), Adjunct Professor at Campbell University Lundy-Fetterman School of Business, and Business Communication Senior Specialist at Cigna. She holds PhD and MSPH degrees from University of North Carolina-Chapel Hill. Patricia A. McKenna, BSN, RN, is currently a Project Manager with Cigna Consumer Health Engagement. She received her BSN from Creighton University, College of Nursing, and is a Certified Six Sigma Green Belt. Yuming Albert Shen, PhD, holds the position of Informatics and Analytics Senior Specialist at Cigna. He holds a PhD in biophysics from University of Virginia, a PhD in statistics from Virginia Tech, and a master's degree in statistics from Columbia University in the City of New York. Bhuvana Sagar, MD, is Lead Medical Director at Cigna. She completed her MD from Kilpauk Medical College in Chennai, India, residency at St. Luke's-Roosevelt Hospital Center, New York, NY, and fellowship at University of Texas-Medical Branch, Galveston, TX. She is board certified in Internal Medicine and Medical Oncology and actively licensed in Texas.

Purpose Of Study: Cigna's oncology case management programs identified the opportunity for case managers to integrate distress screening as recommended by the National Comprehensive Cancer Network (NCCN) in oncology populations. Our purpose in conducting this study was to quantify oncology case management program improvements as a result of using the NCCN Distress Screening Tool to guide telephonic case management. The program improvements we measured comprised more efficient identification of biopsychosocial problems and appropriate resource referrals. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000336DOI Listing
April 2019
3 Reads

Addressing Spiritual and Religious Influences in Care Delivery.

Prof Case Manag 2019 May/Jun;24(3):142-147

Jeannie LeDoux, RN, BSN, MBA, CCM, CPHQ, CTT+, is the 2018-2019 chair of the Commission for Case Manager Certification, the first and largest nationally accredited organization that certifies more than 45,000 professional case managers and over 2,600 disability management specialists. She is also a Senior Clinical Educator at MCG, part of Hearst Health. Her professional work includes work with diverse cultures and with special needs and complex medical issues. She also has extensive experience working with the military. Chikita Mann, MSN, RN, CCM, is a CCMC Commissioner and serves as 2018-2019 Secretary. She is also a disability RN case manager for GENEX Services Inc., for the State of Georgia, responsible for workers' compensation, short- and long-term disability, and legal nurse consulting. Her areas of expertise are cultural competency, worker compensation case management, medication reconciliation, and virtual case management. Michael Demoratz, PhD, LCSW, CCM, is a CCMC Commissioner. With more than 35 years of clinical experience as a social worker in end-of-life care, he currently works for the MemorialCare Hospice and Palliative Services in Orange County, California. Jared Young, PsyD, LCSW, CCM, CADC, is a CCMC Commissioner and serves as 2018-2019 Treasurer. A psychologist, Young has over 20 years of clinical experience in mental health and substance abuse treatment and behavioral health and physical health managed care, and works in Pennsylvania.

Purpose: The impact of spiritual and religious factors on health and care delivery has been identified in case management field research. The purpose of this article is to examine how case managers, taking a holistic, patient-centered approach, are required under professional and ethical standards to address the spiritual and religious influences that may impact the individual's health, care choices, and care delivery.

Primary Practice Settings: Case managers across health or human services must be able to identify and address the spiritual and/or religious factors that may influence a care plan and care delivery. Read More

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http://Insights.ovid.com/crossref?an=01269241-201905000-0000
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http://dx.doi.org/10.1097/NCM.0000000000000346DOI Listing
April 2019
3 Reads

Leveraging Interprofessional Team-Based Care Toward Case Management Excellence: Part 1, History, Fundamentals, Evidence.

Prof Case Manag 2019 May/Jun;24(3):130-141

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, is an award winning, industry thought leader who empowers health care's transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. A subject matter expert on ethics, Ellen is an esteemed author with more than 100 publications to her credit. She has authored content for many of the industry's knowledge projects for case managers, including books, chapters, and articles on the Ethical Use of Case Management Technology, Workplace Bullying, Collaborative Care, and the Social Determinants of Health. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations, including roles as subject matter expert, examination item writer, and leadership positions. She is a vibrant professional voice.

: Health care teams continue to be a constructive way to approach, assess, coordinate, plan, and facilitate the care of clients and populations. Independent of practice setting, some type of team is in place, engaging different professionals and specialists. There has been considerable evolution of these teams over the years, with a heritage of terms to frame each one, including "multidisciplinary," "interdisciplinary," and "transdisciplinary. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000360DOI Listing

Long-Term Services and Supports: A Primer for Case Managers: Part 2.

Authors:

Prof Case Manag 2019 May/Jun;24(3):E1-E2

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http://dx.doi.org/10.1097/NCM.0000000000000369DOI Listing

Long-Term Services and Supports: A Primer for Case Managers: Part 2.

Authors:
Teresa M Treiger

Prof Case Manag 2019 May/Jun;24(3):114-129

Teresa M. Treiger, RN-BC, MA, CCM, CHCQM, FABQAURP, is an industry thought leader inspiring Conscious Case Management practice across the health care continuum through public speaking, professional education, peer mentoring, and publication of professional literature. She is a prolific author in journals, white papers, and courses, as well as academic texts, most recently coeditor and author of the CMSA Core Curriculum for Case Management, 3rd ed. (with Hussein Tahan), coauthor of COLLABORATE for Professional Case Management: A Universal Competency-Based Paradigm (with Ellen Fink-Samnick), and coauthor of Population Health Management, 6th ed., chapter on Leadership and Nursing Case Management (with Ellen Fink-Samnick). Teresa is a past National President of the Case Management Society of America and founding board member of the National Transitions of Care Coalition.

Purpose/objectives: The Centers for Medicare & Medicaid Services (CMS) announced that beginning in 2019, Medicare Advantage (MA) health plans may begin offering additional benefits for nonmedical home services. In 2019, this change impacts the Long-Term Services and Supports (LTSS) landscape dramatically. This 2-part article describes LTSS, its traditional demographic and health care footprint, the regulatory and accreditation landscape, quality measurement and outcomes, and the critical importance of maintaining care continuity for individuals receiving LTSS. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000335DOI Listing
April 2019
2 Reads

Social Determinants of Health: A Timely Topic for Case Management.

Authors:
Suzanne K Powell

Prof Case Manag 2019 May/Jun;24(3):111-113

Social determinants are a critical component of our patients' health, affecting people in both tangible and insidious ways. The World Health Organization (2017) defines Social Determinants of Health as those conditions in which people are born, grow, live, work, and age. Finding resources for those at social risk is a prime directive for case managers. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000367DOI Listing

Evaluation of a Transitional Care Management Tool Using the Logic Model.

Prof Case Manag 2019 Mar/Apr;24(2):101-107

Jessica S. Garner, DNP, FNP, is an assistant professor of nursing at the University of Mobile. She has served as part-time faculty for the Capella University School of Nursing and Troy University School of Nursing. She worked as a nurse practitioner in the inpatient setting in the pulmonary and critical care specialty after graduating with her Master of Science in Nursing degree from the University of Alabama at Birmingham in 2014. This position afforded her the opportunity to gain perspective on why patients are admitted to the hospital and why they return. She began her Doctor of Nursing Practice degree through the University of Alabama at Birmingham in 2016 with the intention of focusing on readmissions and the transitional care window, and this article is the culmination of her work during completion of that degree. During her inpatient work, she participated on subcommittees to initiate smoking cessation in the inpatient setting and reduce 30-day readmissions associated with chronic obstructive pulmonary disorder. Marisa L. Wilson, DNSc, MHSc, RN-BC, CPHIMS, FAAN, is an associate professor and specialty track coordinator for the MSN Nursing Informatics program at the University of Alabama at Birmingham School of Nursing and core faculty member in the Doctor of Nursing Practice program teaching informatics for quality, safety, and the transformation of care. Dr. Wilson is also an associate faculty member for the Informatics Institute of the University of Alabama at Birmingham School of Medicine. In 2006, she transitioned her career to full-time academia after 30 years of clinical care, public health, and operational informatics management work. Dr. Wilson received her master's degree from the Johns Hopkins University Bloomberg School of Public Health and her doctorate degree from the Johns Hopkins University School of Nursing. Dr. Wilson spent more than two decades in epidemiological, clinical, and operational informatics work in public health, acute care, and post-acute care settings. She was a 2012 American Association of Colleges of Nursing Leadership for Academic Nursing fellow. She was the Director of Master's Programs, taught in the MS informatics and DNP programs, and mentored graduate students at both the University of Maryland School of Nursing and the Johns Hopkins University School of Nursing. Dr. Wilson is actively involved in MedBiquitous, AMIA, and HIMSS through her work with informatics continuing education programs and mentorship of new informaticians.

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http://dx.doi.org/10.1097/NCM.0000000000000351DOI Listing
January 2019
3 Reads

Field Case Management: A Unique Advocacy Role.

Authors:
Michelle Baker

Prof Case Manag 2019 Mar/Apr;24(2):99-100

Michelle Baker, BS, RN, CRRN, CCM, is the Chair-Elect of the Commission for Case Manager Certification, the first and largest nationally accredited organization that certifies more than 45,000 professional case managers and more than 2,600 disability management specialists. Michelle is also the Manager, Network Operations for Paradigm Catastrophic Care Management, with primary areas of focus including management of workers' compensation catastrophic nurse case managers and program development and implementation.

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http://dx.doi.org/10.1097/NCM.0000000000000354DOI Listing
January 2019

Competency Versus Capacity.

Authors:
Lynn S Muller

Prof Case Manag 2019 Mar/Apr;24(2):95-98

Lynn S. Muller, JD, BA-HCM, RN, CCM, is an attorney and independent professional case manager. She is an adjunct professor in the MSN and DNP programs at Saint Peter's University of New Jersey where she received her bachelor's degree in Healthcare Management. Lynn is a registered nurse licensed in New York and New Jersey and has been certified case manager for 25 years with extensive nursing and case management experience. Her law practice includes defense of health care professionals before state licensing boards, case management litigation, civil litigation, Wills, Trusts and Estates, and Family law. Lynn is a consultant on such issues as regulatory compliance and accreditation. She has served her community as Councilwoman, Public Defender, and Municipal Court Judge and volunteers as an Early Settlement Panelist for the Family Court. Lynn is the Contributing Editor of the Professional Case Management journal, the official journal of CMSA, and has authored more than 40 articles and the legal chapters of the third and fourth editions of Case Management: A Practical Guide for Education and authored the legal chapter of the third edition of the CMSA Core Curriculum for Case Management and the Legal and Ethical Issues Chapter of Leadership & Nursing Care Management (6th Ed.). Lynn is a contributor to the CMSA Career & Knowledge Pathways Project and Standards of Practice for Case Management. She is a contributor to the CCMC Case Management Body of Knowledge (CMBOK) and facilitator for the CCMC 360 Training Program. Lynn is a former CCMC commissioner and serves on the Professional Development Subcommittee. She is a past president of the NJ Chapter of CMSA.

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http://dx.doi.org/10.1097/NCM.0000000000000348DOI Listing
January 2019
8 Reads

Technology: Is It Our Servant or Our Master?

Authors:
Teresa M Treiger

Prof Case Manag 2019 Mar/Apr;24(2):93-94

Teresa M. Treiger, RN-BC, MA, CCM, FABQAURP is principal of Ascent Care Management, providing private case management, consulting, professional education, and peer mentoring services. She is a past National President of the Case Management Society of America (CMSA) and a founding board member of the National Transitions of Care Coalition.

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http://dx.doi.org/10.1097/NCM.0000000000000353DOI Listing
January 2019

Acute Care and Workers' Compensation Case Managers.

Authors:
Kathleen Fraser

Prof Case Manag 2019 Mar/Apr;24(2):90-92

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http://dx.doi.org/10.1097/NCM.0000000000000352DOI Listing
January 2019

Improving Early Discharge Using a Team-Based Structure for Discharge Multidisciplinary Rounds.

Prof Case Manag 2019 Mar/Apr;24(2):83-89

Purpose Of Study: Miscommunications during the complex process of discharging patients from acute care facilities can lead to adverse events, patient dissatisfaction, and delays in discharge. Brief multidisciplinary discharge rounds (MDRs) can increase communication between stakeholders and shorten a patient's length of stay (LOS). At our tertiary academic medical center, case managers (CMs) have historically been assigned patients by physical unit location rather than by provider teams caring for patients. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000318DOI Listing
January 2019

Health Coaching for Patients With Type 2 Diabetes Mellitus to Decrease 30-Day Hospital Readmissions.

Prof Case Manag 2019 Mar/Apr;24(2):76-82

Veronica H. Sullivan, DNP, MSN, RN, is a clinical assistant professor at The University of Alabama in Huntsville. Dr. Sullivan is an instructor in the BSN program. She has 15 years' experience as a nurse. Her prior experience includes medical-surgical, community health, geriatric, and psychiatric-mental health nursing. Mary M. Hays, DSN, MSN, RN, is associate professor emeritus at The University of Alabama in Huntsville, where her 17-year career included teaching pathophysiology and nursing administration. Dr. Hays' clinical experiences for more than 30 years include intensive cardiac care and step-down units and long-term care as director of nursing and administrative consultant. Susan Alexander, DNP, ANP-BC, ADM-BC, is an associate professor at the University of Alabama in Huntsville, working with graduate students in doctoral and master's programs since 2009. Her clinical areas of interest includes older adults with chronic diseases, specifically diabetes. Her prior experiences include acute, home-based, hospice, and palliative care.

Purpose/objectives: The purpose of this program was to provide health coaching to patients with a primary or secondary diagnosis of Type 2 diabetes mellitus (T2DM) to increase self-management skills and reduce 30-day readmissions.

Primary Practice Setting: The setting was a 273-bed, acute care not-for-profit hospital in the southern region of the United States.

Findings/conclusions: Health coaching that emphasized self-management, empowered patients to set healthy goals, and provided support through weekly reminders to improve self-management for patients with T2DM in this pilot program. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000304DOI Listing
January 2019
18 Reads

Fostering Cross-Sector Partnerships: Lessons Learned From a Community Care Team.

Prof Case Manag 2019 Mar/Apr;24(2):66-75

Diane E. Holland, PhD, RN, is a nurse scientist, Department of Nursing, and associate professor, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN. She is a fellow, Gerontological Society of America and American Academy of Nursing. Her research interests include transitioning adults from the hospital to primary care in the community. Catherine E. Vanderboom, PhD, RN, is a nurse scientist, Department of Nursing, and assistant professor, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN. Her research interests include community-based interventions, especially care coordination, for older adults with multiple chronic health conditions. Tanya M. Harder, MSN, PHN, RN, CCM, is a public health nurse manager, Olmsted County Public Health, Rochester, MN. Her interests include case management of low-income seniors in a community-based setting and interprofessional collaboration to ensure safe and effective transitions across care settings.

Purpose/objectives: The purpose of this study was to describe lessons learned during the development and implementation of a community care team (CCT) and the applicability of this model in movement toward cross-sector team-based care coordination.

Primary Practice Setting: Primary care.

Findings/conclusions: Cross-sector CCTs composed of primary care and community service providers are a care coordination approach that attends to the individual's social determinants of health, enhances the individual's capacity to manage treatment and self-care demands of multiple chronic health conditions, improves the care experience, and impacts well-being. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000310DOI Listing
January 2019

Six Lessons to Guide Intentional Career Action: Homage to the Queen of Soul and a Maverick Senator.

Prof Case Manag 2019 Mar/Apr;24(2):63-65

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, is an award-winning, industry thought leader who empowers health care's transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. A subject matter expert on Ethics, Ellen is an esteemed author with more than 100 publications to her credit. She has authored content for many of the industry's knowledge projects for case managers, including chapters on the Ethical Use of Case Management Technology, Workplace Bullying, Collaborative Care, and the Social Determinants of Health. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations, including roles as subject matter expert, examination item writer, and leadership positions. She is a vibrant professional voice.

Independent of political perspective or musical preferences, the deaths of two individuals who played a major role in history was worthy of a moment of pause. The life lessons inspired by the efforts of these icons, plus the work of motivational author Jon Acuff together serve to empower the intentional action of professional case managers in defining a successful career path. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000337DOI Listing
December 2018
1 Read

Clinical Case Management for Adults With a Developmental Disability in a Medical Home.

Prof Case Manag 2019 Jan/Feb;24(1):56-62

Kyle Bradford Jones, MD, FAAFP, is Family Physician and Director of Primary Care at the Neurobehavior HOME Program and Assistant Professor at the University of Utah School of Medicine, where he teaches medical students and family medicine residents. Nirupma Singh, MPH, MPA, received her dual Master of Public Health and Master of Health Administration from the University of Utah and has a Bachelor in Dental Surgery degree. Her research interests include improving health care through planning, management, and evaluation of quality improvement initiatives with focus on people with developmental disabilities. Vanessa Galli, MS, earned her medical degree from the University of Vermont. She completed her residency in Family Medicine at the University of Utah, where she served as Chief Resident. Dr. Galli currently practices at Intermountain West Valley Clinic in West Valley City, Utah. Dean Weedon, MSc, is the former director of the University of Utah Neurobehavior HOME Program and Autism Spectrum Disorder Clinic. He is currently a Quality Improvement Consultant at the Utah Department of Health. Paul Carbone, MD, is Associate Professor of Pediatrics at the University of Utah. His clinical and research interests revolve around the primary care of children and youth with autism spectrum disorder.

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http://Insights.ovid.com/crossref?an=01269241-201901000-0001
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http://dx.doi.org/10.1097/NCM.0000000000000343DOI Listing
February 2019
24 Reads

Quantifying Outcomes and Value: A Case Management Imperative.

Prof Case Manag 2019 Jan/Feb;24(1):53-55

Vivian Campagna, MSN, RN-BC, CCM, is the Chief Industry Relations Officer for the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that certifies case managers, and a former CCMC Commissioner. She has been active in case management for more than 25 years in independent practice as well as in acute care where she directed case management and social work departments. In her current position with CCMC, she draws on her expertise in the field and passion for certification to establish relationships with organizations that advocate for or promote the services of case management. Teresa Yancey, JD, RN, CCM, is a Commissioner of the CCMC and a Director of Affordability and Solutions for a Fortune 50 company. She is also licensed as an attorney in Georgia.

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http://dx.doi.org/10.1097/NCM.0000000000000342DOI Listing
February 2019
1 Read

The Economics of Case Management.

Authors:
Lynn S Muller

Prof Case Manag 2019 Jan/Feb;24(1):49-52

Lynn S. Muller, JD, BA-HCM, RN, CCM, is an attorney and independent professional case manager. She is an adjunct professor in the MSN and DNP programs at Saint Peter's University of New Jersey where she received her bachelor's degree in Healthcare Management. Lynn is a registered nurse licensed in New York and New Jersey and has been certified case manager for 25 years with extensive nursing and case management experience. Her law practice includes defense of health care professionals before state licensing boards, case management litigation, civil litigation, Wills, Trusts, and Estates, and Family law. Lynn is a consultant on such issues as regulatory compliance and accreditation. She has served her community as Councilwoman, Public Defender, and Municipal Court Judge and volunteers as an Early Settlement Panelist for the Family Court. Lynn is the Contributing Editor of the Professional Case Management Journal, the official journal of CMSA, and has authored more than 40 articles and the legal chapters of the third and fourth editions of Case Management: A Practical Guide for Education and authored the legal chapter of the third edition of the CMSA Core Curriculum for Case Management and the Legal and Ethical Issues Chapter of Leadership & Nursing Care Management (6th Ed.). Lynn is a contributor to the CMSA Career & Knowledge Pathways Project and Standards of Practice for Case Management. She is a contributor to the CCMC Case Management Body of Knowledge (CMBOK). Lynn is as a former commissioner and member of the ethics committee for CCMC and a past president of the N.J. Chapter of CMSA. She is currently a member of the Board of Directors of CMSA of New York City.

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http://dx.doi.org/10.1097/NCM.0000000000000341DOI Listing
February 2019
11 Reads

Taking the First Step of a New Journey.

Authors:
Teresa M Treiger

Prof Case Manag 2019 Jan/Feb;24(1):48

Teri M. Treiger, RN-BC, MA, CCM, CHCQM, FABQAURP, is a thought leader inspiring Conscious Case Management© practice across the health care continuum through public speaking, professional education, peer mentoring, and publication. She is a prolific author in journals and books, most recently as co-editor and contributing author of CMSA Core Curriculum for Case Management, 3rd ed., co-author of COLLABORATE© for Professional Case Management. Teresa is principal at Ascent Care Management. She is a past National President of the Case Management Society of America (CMSA).

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http://dx.doi.org/10.1097/NCM.0000000000000340DOI Listing
February 2019
1 Read

Care Progression: Care Management Alignment.

Authors:
Jose Alejandro

Prof Case Manag 2019 Jan/Feb;24(1):46-47

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http://dx.doi.org/10.1097/NCM.0000000000000339DOI Listing
February 2019
2 Reads

Excellence in Population Health: A Successful Community-Based Care Transitions Program Model.

Prof Case Manag 2019 Jan/Feb;24(1):39-45

Cheryl Warren, MSN, RN, is currently the Chief Clinical Integration Officer at Hallmark Health System, Medford, MA, with responsibility for Ambulatory Services, Case Management, Utilization Management, and Social Work, as well as strategic planning for transitions of care in the post-acute community. She has 14 years' experience in nursing leadership, specializing in case management. Amy A. Lemieux, PharmD, BS, is a pharmacist focusing on Transitions in Care at Hallmark Health System, Medford, MA. She is an adjunct faculty member of MCPHS University and WNEU College of Pharmacy. Amy was previously a clinical supervisor at Hallmark Health System and prior to that a clinical pharmacist at McLean Hospital. Nancy Phoenix Bittner, PhD, CNS, RN, is Vice President for Education at Lawrence Memorial/Regis College Nursing and Radiography Programs and Research Scientist at Hallmark Health System, Medford, MA. Her program of research is focused on cognitive processing nursing practice. She has had several research publications and presentations related to her research nationally and internationally.

Purpose/objective: The Community-based Care Transitions Program (CCTP) defined a broad spectrum of interventions and services for elderly patients at high risk of hospital readmission. The purposes for a CCTP as developed by the Centers for Medicare & Medicaid Services are to improve transitions of beneficiaries from the inpatient hospital setting to other care settings, to improve quality of care, to reduce readmissions for high-risk beneficiaries, and to document measurable savings. The goals for this CCTP initiative were as follows: achievement of a 20% reduction in the 30-day all-cause readmission rate across all partner hospitals compared with baseline; reduction in the 30-day all-cause readmission rate among the high-risk cohort served; and achievement of the target volumes for full enrollment. Read More

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http://Insights.ovid.com/crossref?an=01269241-201901000-0000
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http://dx.doi.org/10.1097/NCM.0000000000000303DOI Listing
February 2019
19 Reads

Population Health Management: Coming of Age.

Authors:
Karen Zander

Prof Case Manag 2019 Jan/Feb;24(1):26-38

Karen Zander, MS, RN, CMAC, FAAN, is President and CEO of The Center for Case Management. Her pioneering work with clinical case management and CareMap systems, begun at New England Medical Center Hospitals (Now Tufts Medical Center) in Boston more than 30 years ago, is internationally recognized. Hospitals and Health Networks named her a "Cutting Edge" leader. She is the author of many articles about case management and editor of The New Definition newsletter. Ms Zander has also written several case management texts: (1) Competency Evaluation Tools for Case Management Professionals, (2) Emergency Department Case Management: The Compendium of Best Practices second edition with K. Walsh, and Hospital Case Management Models: Evidence Connecting the Bedside to the Boardroom and a second edition: Case Management Models: Best Practices for Health Systems and ACOs, also from HCPro. Ms Zander holds a BSN from Illinois Wesleyan University, an MS in Psychiatric-Mental Health Nursing from Boston University, postgraduate credits from Massachusetts Institute of Technology, and a Doctorate in Humane Letters (DHL), honoris causa, from Illinois, Wesleyan University. She has been on the Partners Care at Home Patient/Family Advisory Board for 3 years, and has been a cellist in the New Philharmonia Orchestra for over 25 years.

Purpose: Population health is finally catching up with itself. Before it was known as disease management, it began at New England Medical Center in Boston, MA (now Tufts Medical Center), more than 30 years ago.

Implications For Case Management Practice: Take-away ideas: (1) population health management is about segmenting and targeting specific patient populations for interventions that are evidence based; (2) there are currently many examples of population health management; (3) population health management will not work without social workers and nurse navigators/care coordinators working side by side. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000265DOI Listing
February 2019
2 Reads

Incorporating Patient-Centeredness Into Case Management Practice: Concepts, Interventions, and Measurement.

Prof Case Manag 2019 Jan/Feb;24(1):17-25

Michael B. Garrett, MS, CCM, CVE, NCP, BCPA, has more than 30 years of experience in case/care management, utilization management, and health care quality in a wide range of benefit systems. He holds a Master of Science in clinical psychology, and he is a Certified Case Manager, Certified Vocational Evaluator, Nationally Certified Psychologist, and Board-Certified Patient Advocate.

Purpose Of Manuscript: Patient-centeredness is a cornerstone of case management practice. Professional case managers must conduct a clinical assessment to develop a care plan that addresses the clinical issues as well as the patient's needs, preferences, values, and choices. To achieve patient-centeredness, the case manager must engage with the patient in order to build a relationship that supports the patient-identified goals and addresses gaps in care. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000323DOI Listing
February 2019
1 Read

Long-Term Services and Supports: A Primer for Case Managers: Part 1.

Authors:
Teresa M Treiger

Prof Case Manag 2019 Jan/Feb;24(1):4-16

Teresa M. Treiger, RN-BC, MA, CCM, CHCQM, FABQAURP, is an industry-thought leader inspiring Conscious Case Management© practice across the health care continuum through public speaking, professional education, peer mentoring, and publication of professional literature. She is a prolific author in journals, white papers, and courses as well as academic texts, most recently co-editor and author of the CMSA Core Curriculum for Case Management, 3rd ed. (with Hussein Tahan), co-author of COLLABORATE© for Professional Case Management: A Universal Competency Based Paradigm (with Ellen Fink-Samnick), and co-author of Population Health Management, 6th ed., chapter on Leadership and Nursing Case Management (with Ellen Fink-Samnick). Teresa is a past National President of the Case Management Society of America and founding board member of the National Transitions of Care Coalition.

Purpose/objectives: The Centers for Medicare & Medicaid (CMS) announced that, beginning in 2019, Medicare Advantage health plans may begin offering additional benefits for nonmedical home services. In 2019, this change impacts the Long-Term Services and Supports (LTSS) landscape dramatically. This two-part article describes LTSS, its traditional demographic and health care footprint, the regulatory and accreditation landscape, quality measurement and outcomes, and the critical importance of maintaining care continuity for individuals receiving LTSS. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000331DOI Listing
February 2019
7 Reads

Choosing Medicare Advantage Plans Versus Traditional Fee-for-Service: Is This Change the Tipping Point?

Authors:
Suzanne K Powell

Prof Case Manag 2019 Jan/Feb;24(1):1-3

Beginning in 2019, the Centers for Medicare & Medicaid Services is expanding the definition of "primarily health-related." Under the new definition, Medicare Advantage Plans allow beneficiaries supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency department utilization. At the discretion of the plan, this could expand the scope of permitted services to include things such as nonskilled in-home workers, portable wheelchair ramps, and other assistive devices. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000338DOI Listing
February 2019
2 Reads

Online Education and Case Management.

Prof Case Manag 2018 Nov/Dec;23(6):353-355

Jennifer T. Lauderdale, BA, received her Bachelor of Arts degree in Criminal Justice with an emphasis in Sociology from California State University, Bakersfield. She was a program facilitator at the New Directions Group Home for Girls, a specialized facility responsible for children aged birth to 17 years, including teen mothers and their babies. Jennifer was responsible for medication supervision, nutrition, supporting activities of daily living, enabling the teen mothers to attend school without their children, tutoring, life skills instructor, and vocation counseling. After moving to Colorado in 2008, she worked for 6 years for the 18th Judicial District Juvenile Assessment Center, where she had the privilege of working with children and their families throughout Arapahoe, Douglas, Elbert, and Lincoln counties by coordination services and navigating the juvenile justice system. As a learning coach for the past 4 years, she has come to love and advocate for online education and all its benefits. She was and is so enthusiastic about the opportunity to share her knowledge, insight, and experience so much so that she became a family compliance liaison for Colorado Preparatory Academy and Pikes Peak Online School to further the mission and vision that she has been so passionate about. When Jennifer is not working, you may find her fishing and camping with her family at one of Colorado's state parks.

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http://dx.doi.org/10.1097/NCM.0000000000000330DOI Listing
January 2019
2 Reads

Public Policy in Action: Advocating for Case Management Practice.

Authors:
Vivian Campagna

Prof Case Manag 2018 Nov/Dec;23(6):351-352

Vivian Campagna, MSN, RN-BC, CCM, is the chief industry relations officer for the Commission for Case Manager Certification, the first and largest nationally accredited organization that certifies case managers. Vivian has been involved in case management for more than 25 years, holding staff and administrative positions on both the independent and acute care sides of the industry.

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http://dx.doi.org/10.1097/NCM.0000000000000329DOI Listing
January 2019
1 Read

Texting and Case Management.

Prof Case Manag 2018 Nov/Dec;23(6):347-350

Suzanne von Santen-Tambasco, BSN, MAED, CCM, CRRN, COHNS, NCLCP, LNCC, MSCC, has 24 years of case management experience. She is a certified case manager, legal nurse consultant, occupational health nurse, Medicare Set-Aside Consultant, rehabilitation nurse, and nurse life care planner. Suzanne received her BSN and her master's degree in adult education from Medical University of South Carolina (MUSC). She is currently a doctoral candidate at MUSC in Charleston, South Carolina, completing her DNP/NP in psych-mental health in May 2019. Suzanne speaks Spanish, Italian, French, and English. She is the Director of Case Management for MMI Medical Management Services in Atlanta, Georgia.

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http://dx.doi.org/10.1097/NCM.0000000000000328DOI Listing
January 2019
7 Reads

Signing Off...

Authors:
Mindy Susan Owen

Prof Case Manag 2018 Nov/Dec;23(6):345-346

Mindy Susan Owen, RN, CRRN, CCM, is the principal of Phoenix Healthcare Assoc. LLC, Coral Springs, FL, specializing in case management education and management. Mindy's career in health care has included critical care neurosurgery and rehabilitation. She helped design and implement an SCI-TBI rehabilitation department at Wesley Regional Medical Center in Wichita, KS. Mindy was the first Midwest Regional Director of Case Management for Intracorp and has developed and directed both acute and MCO CM/DM programs nationwide. She is Charter Board member and Past President of CMSA, and Past Chair and Commissioner of CCMC.

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http://dx.doi.org/10.1097/NCM.0000000000000327DOI Listing
January 2019
1 Read

Under the Case Management Practice "Umbrella": CMSA's Standards and CCMC's Code of Conduct.

Prof Case Manag 2018 Nov/Dec;23(6):342-344

Commission for Case Manager Certification.

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http://dx.doi.org/10.1097/NCM.0000000000000326DOI Listing
January 2019
5 Reads

Evaluation of a Hospital: Community Partnership to Reduce 30-Day Readmissions.

Prof Case Manag 2018 Nov/Dec;23(6):327-341

Diahann Wilcox, DNP, APRN, ACNP-BC, is currently a Nurse Practitioner at the University of Connecticut Health Center in pulmonary medicine. Her work focuses on ensuring safe and quality care for individuals with chronic conditions. Paula S. McCauley, DNP, APRN, ACNP-BC, CNE, is Associate Clinical Professor and Coordinator of the Adult Gerontology Acute Care Nurse Practitioner Track at the University of Connecticut School of Nursing, Storrs, CT. She has more than 35 years in critical care and served as a director of the American Association of Critical-Care Nurses. Colleen Delaney, PhD, RN, AHN-BC, is Associate Professor at the University of Connecticut School of Nursing, Storrs, CT. Dr. Delaney is the Coordinator of the RN-MS and Graduate Certificate in Holistic Nursing programs at the University of Connecticut. Sheila L. Molony, PhD, APRN, GNP-BC, is Associate Professor at Quinnipiac University School of Nursing, Hamden, CT. She has more than 30 years of nursing experience in community, nursing home, and hospital settings. Dr. Molony conducts research on the meaning of "home" to older adults.

Purpose: To evaluate the ComPass program by (1) effectiveness in reducing 30-day hospital readmissions, (2) reach of program into target population, and (3) implementation of key program elements.

Primary Practice Setting: An academic hospital in New England (John Dempsey Hospital).

Methodology And Sample: Retrospective analysis of Medicare fee-for-service (FFS) beneficiaries hospitalized at John Dempsey Hospital between May 1, 2012, and November 30, 2014. Read More

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http://Insights.ovid.com/crossref?an=01269241-201811000-0000
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http://dx.doi.org/10.1097/NCM.0000000000000311DOI Listing
January 2019
4 Reads

Improving Functional Assessment in Older Adults Transitioning From Hospital to Home.

Prof Case Manag 2018 Nov/Dec;23(6):318-326

Daniel Liebzeit, RN-BSN, is a nurse by background and PhD candidate at the University of Wisconsin-Madison School of Nursing with research focusing on advancing knowledge of functional status in older adults and improving outcomes during the transition from hospital to home. Barbara King, PhD, RN, is a geriatric nurse practitioner and Assistant Professor in the University of Wisconsin-Madison School of Nursing. She is dedicated to creating sustainable and scalable practice change to promote patient safety for hospitalized older adults. Lisa Bratzke, PhD, RN, is an adult nurse practitioner and Assistant Professor in the University of Wisconsin-Madison School of Nursing. Her research interests include examining the effects of accelerated cognitive decline on functional status and self-management, two important factors related to an older adult's ability to live independently. Marie Boltz, PhD, RN, is a geriatric nurse practitioner and Associate Professor in the Pennsylvania State University College of Nursing. Her research includes examination of complex aging-related care issues and interventions to promote functional health and cognition in older adults.

Purpose/objectives: The purpose of this article is to highlight how scientists have assessed all components of functional status in older adults transitioning from hospital to home to date, discuss ways of improving assessment of functional status, and discuss implications for case management research and practice.

Primary Practice Setting(s): This article focuses on case management of older adults transitioning from hospital to home.

Findings/conclusions: There any many ways to assess functional status, including basic activities of daily living (BADL), instrumental activities of daily living (IADL), and other nonphysical domains of function such as leisure, social, and productive activities. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176726PMC
January 2019
12 Reads

The Best Practice for Increasing Telephone Outreach: An Integrative Review.

Prof Case Manag 2018 Nov/Dec;23(6):307-317

Franz H. Vergara, PhD, DNP, RN, ONC, CCM, is Nurse Educator, Department of Central Nursing Administration at the Johns Hopkins Hospital, Baltimore, MD. Dr. Vergara has more than 15 years of professional experience including acute care nursing, case management/care coordination, research, and nursing education. Nancy J. Sullivan, DNP, RN, is Assistant Professor and Simulation Director at the Johns Hopkins University School of Nursing, Baltimore, MD. Dr. Sullivan has served as a clinical nurse specialist for the hospital readmission task force at the Johns Hopkins Hospital. Daniel J. Sheridan, PhD, RN, FAAN, is Professor and Director of Forensic Health Care, Education, and Research Program at Texas A&M University, College of Nursing. Jean E. Davis, PhD, RN, FAAN, is the Paul J. McKee Jr. Senior Associate Dean for Research and Doctoral Studies, Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, MO.

Purpose Of Study: Many hospitals established telephone follow-up (TFU) programs to improve care transitions and reduce hospital readmissions. However, there is a lack of knowledge on how to increase the outreach of TFU programs. This integrative review aims to answer the clinical practice question, "What is the best practice for increasing telephone follow-up reach rates post-hospital discharge?"

Primary Practice Setting: The primary setting evaluated in this review was hospital-based phone call programs that are conducting post-hospital discharge TFU. Read More

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http://Insights.ovid.com/crossref?an=01269241-201811000-0000
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http://dx.doi.org/10.1097/NCM.0000000000000296DOI Listing
January 2019
58 Reads

The New Age of Bullying and Violence in Health Care: Part 4: Managing Organizational Cultures and Beyond.

Prof Case Manag 2018 Nov/Dec;23(6):294-306

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, is an award-winning industry thought leader who empowers health care's transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. A subject matter expert on ethics, Ellen is an esteemed author with more than 100 publications to her credit. She has authored content for many of the industry's knowledge projects for case managers, including chapters on the Ethical Use of Case Management Technology, Workplace Bullying, Collaborative Care, and the Social Determinants of Health. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations, including roles as subject matter expert, examination item writer, and leadership positions. She is a vibrant professional voice.

Disrespect among the health and behavioral health workforce may have reached the point of no return. The industry is on heightened alert, as the disruptive behaviors of bullying and lateral violence, plus escalating incidents of workforce harassment and workplace violence incidents, impact every practice setting. These behaviors contribute to concerns around client and professional safety, quality-of-care processes, as well as workforce retention and mental health. Read More

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http://dx.doi.org/10.1097/NCM.0000000000000324DOI Listing
January 2019
3 Reads

Leadership Presence: A "Must" Skill for Impactful Case Manager-Client Relationship.

Authors:
Hussein M Tahan

Prof Case Manag 2018 Nov/Dec;23(6):289-293

Hussein M. Tahan, PhD, RN, FAAN, is a case management consultant, expert, author, and researcher. Dr Tahan has more than 25 years of experience in hospital management and operations and case management practice, is a member of the Professional Case Management journal's editorial advisory board, coauthor of multiple textbooks on case management including CMSA's Core Curriculum for Case Management and Case Management: A Practical Guide for Education and Practice, chief knowledge editor of the Case Management Body of Knowledge online portal sponsored by the Commission for Case Manager Certification, and the recipient of CMSA's 2016 Lifetime Achievement Award for his contribution to the field of case management. Dr Tahan can be reached at

Successful case manager-client relationships are those that demonstrate a humanistic, personal, empathetic, and empowering approach to health care provision. This editorial discusses leadership presence as an essential skill for professional case management practice and the impact of such relationships on the client/support system experience of care. It also presents a framework for building impactful and therapeutic relationships. Read More

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http://Insights.ovid.com/crossref?an=01269241-201811000-0000
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http://dx.doi.org/10.1097/NCM.0000000000000325DOI Listing
January 2019
2 Reads

Advocacy for Health Care Policy in Case Management: An Ethical Mandate.

Authors:
Donna Messutta

Prof Case Manag 2018 Sep/Oct;23(5):282-287

Donna Messutta, DBioethics, MA, BSN, RN, is a case manager in the Medical/Cardiac ICU at Advocate Lutheran General Hospital in Park Ridge, IL, a Level I trauma center on the northwest border of Chicago. Donna earned a BSN from Loyola University of Chicago, MA and Doctorate of Bioethics and Healthcare Policy from the Neiswanger Institute for Bioethics at the Loyola University Stritch School of Medicine. Donna considers care management providers as uniquely positioned to be ethical champions, particularly in lieu of their direct involvement with shared decision-making, impact on care planning, and role as advocates.

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http://dx.doi.org/10.1097/NCM.0000000000000315DOI Listing
December 2018
1 Read

The Opioid Epidemic: The Crisis That Hits Home.

Authors:
MaryBeth Kurland

Prof Case Manag 2018 Sep/Oct;23(5):280-281

MaryBeth Kurland, CAE, is the CEO of the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that certifies case managers. Currently, more than 45,000 board-certified case managers with the Certified Case Manager (CCM) credential are currently in practice.

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http://dx.doi.org/10.1097/NCM.0000000000000314DOI Listing
December 2018
3 Reads

Hot Topics in Legal Compliance.

Authors:
Lynn S Muller

Prof Case Manag 2018 Sep/Oct;23(5):276-279

Lynn S. Muller, JD, BA-HCM, RN, CCM, is an attorney and independent professional case manager. She is an adjunct professor in the MSN and DNP programs at Saint Peter's University of New Jersey where she received her bachelor's degree in Healthcare Management. Lynn is a registered nurse licensed in New York and New Jersey and has been certified case manager for 25 years with extensive nursing and case management experience. Her law practice includes defense of health care professionals before state licensing boards, case management litigation, civil litigation, Wills, Trusts, and Estates, and Family law. Lynn is a consultant on such issues as regulatory compliance and accreditation. She has served her community as Councilwoman, Public Defender, and Municipal Court Judge and volunteers as an Early Settlement Panelist for the Family Court. Lynn is the Contributing Editor of the Professional Case Management Journal, the official journal of CMSA, and has authored more than 40 articles and the legal chapters of the third and fourth editions of Case Management: A Practical Guide for Education and authored the legal chapter of the third edition of the CMSA Core Curriculum for Case Management and the Legal and Ethical Issues Chapter of Leadership & Nursing Care Management (6th Ed.). Lynn is a contributor to the CMSA Career & Knowledge Pathways Project and Standards of Practice for Case Management. She is a contributor to the CCMC Case Management Body of Knowledge (CMBOK). Lynn is as a former commissioner and member of the ethics committee for CCMC and a past president of the N.J. Chapter of CMSA. She is currently a member of the Board of Directors of CMSA of New York City.

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http://dx.doi.org/10.1097/NCM.0000000000000316DOI Listing
December 2018
12 Reads

Not Such a Beautiful Day in the Neighborhood.

Authors:
Teresa M Treiger

Prof Case Manag 2018 Sep/Oct;23(5):274-275

Teresa M. Treiger, MA, RN-BC, CCM, FABQUARP, is a thought leader inspiring Conscious Case Management© practice across the health care continuum through public speaking, professional education, peer mentoring, and publication. She is a prolific author in journals and books, most recently as co-editor and contributing author of CMSA Core Curriculum for Case Management, 3rd ed., co-author of COLLABORATE© for Professional Case Management. Teresa is principal at Ascent Care Management. She is a past National President of the Case Management Society of America (CMSA).

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http://dx.doi.org/10.1097/NCM.0000000000000313DOI Listing
December 2018
1 Read

National Case Management Week 2018.

Authors:
Kathleen Fraser

Prof Case Manag 2018 Sep/Oct;23(5):272-273

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http://dx.doi.org/10.1097/NCM.0000000000000312DOI Listing
December 2018
1 Read

Implementing Posthospital Interprofessional Care Team Visits to Improve Care Transitions and Decrease Hospital Readmission Rates.

Prof Case Manag 2018 Sep/Oct;23(5):264-271

Stacy M. Baldwin, DNP, FNP-BC, is the Doctor of Nursing Practice for Charter Health Care Group in Rancho Cucamonga, California. She received her DNP from James Madison University and her Bachelor's and Master's degrees specializing as a family nurse practitioner from the Virginia Commonwealth University School of Nursing. She has over 10 years of experience in management of chronic disease populations and in implementing transitional care models for high-risk patients. As a Lean Six-Sigma Greenbelt, she has vast experience in clinical innovation and has presented her work at local, state, and national health care conferences. Sharon Zook, DNP, FNP-BC, is a professor in the School of Nursing and Graduate School at James Madison University. She has over 30 years of teaching experience, with 12 at the graduate level. She has participated in funded research and has presented and published on teaching pedagogies, international education and chronic illness management. Her clinical expertise is chronic illness self-care and management. She is licensed as a Master Trainer for the Chronic Disease Self-Management and Diabetes Self-Management Program out of Stanford University. Dr Zook has conducted numerous client and leader trainings. Julie Sanford, DNS, RN, FAAN, is a professor and Director of the School of Nursing at James Madison University. She has published and presented in the areas of interprofessional education and collaborative practice, health policy, informal caregiving, and the scholarship of teaching and learning. She has taught at all levels of nursing education and obtained HRSA funding to lead development of one of the first BSN to DNP adult gerontological acute care NP programs in the country. She became a fellow in the American Academy of Nursing in 2017 and has served as the Director at JMU since 2011. She is a graduate of the University of Alabama, University of South Alabama and LSU Health Science Center.

Purpose/objectives: Today's health care climate is composed of patients who experience complex conditions with multiple comorbidities, requiring higher utilization of acute care services. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, posthospital follow-up clinic (Discharge Clinic) is one approach that can be used to improve transitions of care and decrease preventable hospital readmissions. Read More

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http://Insights.ovid.com/crossref?an=01269241-201809000-0000
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http://dx.doi.org/10.1097/NCM.0000000000000284DOI Listing
December 2018
6 Reads