Case Management Infrastructure
According to Dana Carr, MS, BSN, RN, director of case management at Hebrew Hospital Home Inc. in Bronx, NY, case managers in a subacute setting should have or have access to:
- Office space to increase accessibility of the case manager
- Desktop or laptop computer
- Access to equipment including fax machine, photocopier, telephone, pager, e-mail
- Access to continuing education both inside and outside the facility
- Subscriptions to relevant journals
- Business cards and relevant marketing materials that identify the organization’s mission, vision, values, and goals
Role of the case manager in subacute care
- Interface with admitting, nursing, rehabilitative therapy, social work, pharmacy, finance, and quality assurance
- Identify patients and coordinate care
- Participate in the development and implementation of the care plan and the ongoing evaluation of specific skilled interventions
- Ensure that documentation is appropriate
- Attend daily rounds on subacute admissions
- Work with finance and quality assurance to effect appropriate resolutions
- Assist in the coordination of discharge planning by consulting with the patient and family, social worker, managed care organization and others
- Collaborate with the patient’s primary care physician along with the physician at the skilled nursing facility (SNF) in order to provide a smoother transition
- Market the organization’s programs and services
- Act as a liaison between the SNF and other facilities
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