The Case manager
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Patient safety has become a key issue in health care since the Institute of Medicine (IOM) released the report To Err Is Human: Building a Safer Health System. This landmark report examined the extent of preventable patient injuries and deaths occurring in US hospitals. ⋯ Subsequent studies suggest that the medical error rate is even higher. These statistics are a call to action for case managers to explore creative ways to implement patient safety practices in their systems and procedures.
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The Case Management Society of America (CMSA) was pleased to announce the winner of the first annual Award for Excellence in Adherence Management (AEAM), presented to the case manager who used CMSA's Case Management Adherence Guidelines (CMAG) and CMAG Tracker database most effectively in 2005. Jerri Post was awarded the AEAM at CMSA's 15th Annual Conference in Orlando, Florida. CMAG provides the first evidence-based guidelines for case managers to support health behavior change interventions. Pfizer, Inc. partnered with CMSA to provide national CMAG training programs for CMSA members and sponsored the award.
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A 3-year initiative to provide chronic care services for Medicare fee-for-service (FFS) beneficiaries with diabetes or congestive heart failure is putting the spotlight on how case management teamed with disease management can improve clinical outcomes, generate cost savings, and improve patient and provider satisfaction.
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Hospital overcrowding is primarily a shortage of inpatient beds, not a lack of emergency department capacity, as initially assumed. According to Asplin et al., many factors contribute to overcrowding, including inadequate or inflexible nurse-to-patient staffing ratios, isolation precautions, or delays in cleaning rooms after patient discharge; an overreliance on intensive care or telemetry beds; inefficient diagnostic and ancillary services on inpatient units; and delays in discharging hospitalized patients to postacute-care facilities. Hospital overcrowding presents a challenge for hospital employees and clients, often leading to frustration and dissatisfaction. ⋯ Beds in the critical care units become filled with inappropriate patients if floor beds are not available, making placement of seriously ill patients difficult. Trauma patients may have to be diverted to other hospitals to receive the appropriate level of care. Patients who require specialty services may have to wait for extended periods to obtain a bed in a referral center.
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Case managers certainly come across or suspect medical errors. This article offers a glimpse into the variety of mishaps, possible errors, and even moral ambiguities connected with errors that a case manager may experience. The primary objective of the article is simply to give readers an idea of the kinds of error scenarios a case manager may encounter. The cases appearing here are taken from actual accounts.