Nursing Case Management : A Practical Guide to Success in Managed Care Book

1	What Is a Case Manager?	3
2	Goals of Case Management	11
3	Essential Characteristics and Job Responsibilities	17
4	Opportunities in Nursing Case Management	33
5	Insurance	45
6	Utilization Management	77
7	Legal Issues for Case Managers	143
8	Ethical Issues and Dilemmas	169
9	Quality Improvement and Risk Management	187
10	Discharge Planning: Understanding the Levels of Care and Transfers	209
11	Introduction to the Case Management Process	241
12	Stage I: Case Screening and Selection	247
13	Stage II: Assessment - The Critical Link Between the Patient and the Treatment Plan	253
14	Stage III: Coordination and Development of Treatment and Discharge Plans	263
15	Stage IV: Continuous Case Management - Monitoring, Reassessing, Reevaluating	269
16	Stage V: Implementation of the Final Plan	281
17	Stage VI: Final Evaluation - Postdischarge Follow-up and Case Closure	285
18	Job Stress Versus Success Factors for Case Management	295
19	A Day in the Life of a Nurse Case Manager	309
20	A Case Study With and Without Case Management	315
21	Case Studies	319
	Appendices	331
	Appendix A: The Medicare DRGs	333
	Appendix B: Important Addresses and Phone Numbers	347
	Bibliography	349
	Glossary	361
	Index	373