The majority of existing texts address hospital case management as a ‘nursing practice.’ And while it is true that most hospital case managers are, in fact, nurses, few of them are responsible for clinical care. This text addresses the role of the hospital case manager from a business perspective rather than a nursing perspective. It speaks to the relationship the case manager has with the executive team, managed care contracting office, decision support specialists, medical records staff, as well as the medical staff and clinical providers and reveals the value of engaging all of them as allies in pursuit of global objectives on behalf of every patient.
In my years of experience as a hospital-based nurse administrator responsible for Case Management services, I have never found a resource as relevant, concise, and straightforward as this one. Stefani and Marianne speak to the issues and challenges associated with planning, re-designing, and sustaining a hospital-based Case Management program as no one else has. Without a doubt, this book will be an invaluable reference for program planners and administrators for years to come. I am grateful to J&B for selecting this book for publication and am very pleased to recommend it to others.
—Paula Radell, RN, MSN
Director of Quality Management
Chesapeake General Hospital
Features & Benefits
Explores the premise that the business of healthcare must be the business of case managers.
Makes a case that today’s healthcare crisis demands a radical new approach to hospital case management.
Establishes the rationale and provides the resources to plan and implement an innovative clinical resource management model of hospital case management.
Offers practical tips on staffing and assignments.
Shows how to create an outcome report to demonstrate value to the hospital executives.
Provides ‘best practice’ alternatives from real life situations.
Offers a practical alternative to the traditional UR/DCP model.
Includes real life samples of tools and resources.
Includes guest commentaries at the end of each chapter from people who ‘live’ hospital case management.
Stefani Daniels, MSNA-Phoenix Medical Management, Inc.
Stefani Daniels is the Managing Partner of Phoenix Medical Management a national consulting firm exclusively devoted to solutions for hospital case management programs. She is a former hospital administrator and has held faculty appointments in Columbia University, University of Pennsylvania and Nova Southeastern University’s School of Business and Entrepreneurship in Ft. Lauderdale, Florida. She serves on the editorial board of Lippincott’s Case Management journal, authored several articles on case management, makes frequent appearances as a guest speaker at regional and national meetings, and has been providing case management consulting and education programs to clients across the country since 1994.
Marianne McHale Ramey, RN, CCMS-Phoenix Medical Management, Inc.
Marianne Ramey is a Partner in the Pompano Beach office of the consulting firm of Phoenix Medical Management, Inc. Marianne is an expert in hospital case management operations utilizing the PHOENIX philosophy and frequently serves as the interim leader during transition projects. As a former management consultant with Johnson & Johnson and as the operations partner at Phoenix, Marianne has engineered the design, execution, and hospital-wide preparations for case management programs in hospitals across the country. Marianne is currently Supervisor, Quality Clinical Resource Management, Westchester Medical Center, Valhalla, NY.