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Health Care Case Management Analysis

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MHM505 - Introduction to Quality Assurance
Module 4 - SLP
Case Management

The Session Long Project for this course is to evaluate and critique a health care facility you are familiar with and compare it to the general principles and standards for quality assurance presented in this course.
In the earlier modules you identified a health care facility for the subject of the SLP and presented a description of the facility and its quality assurance program. You also critiqued the facility's Continuous Quality Improvement program and the Utilization Management Program
In this module you will discuss and critique the subject facility's Case Management program. The remaining modules for the Session Long Project the remaining tasks are as follows:
Module V. Discussion of the subject facility's Risk Management program will be presented.
Module VI. This is a summary or wrap-up module. You will complete your SLP and submit it, if you have not already done so.
MODULE FOUR SLP ASSIGNMENT
For this module you are to complete the following tasks:

• Describe and discuss the facility's Case Management program.
• Compare and critique the subject facility's Case Management program to that of a model facility and whether the facility adheres to the recognized standard for case management, including disease state management.
• Determine if the facility's quality assurance program results in the patients being helped to maximize their health care benefits.
• Identify areas for improvement in the facility's Case Management program, if any and any recommendations you think should be implemented to improve the quality of patient care.

Session Long Project Assignment Expectations
Length: SLP assignments should be at least 4-5 pages in length.
References: At least two references should be included from academic sources (e.g. peer-reviewed journal articles). When material is copied verbatim from external sources, it MUST be enclosed in quotes. The references should be cited within the text and also listed at the end of the assignment in the References section (preferably in APA format).
Organization: Subheadings should be used to organize your paper according to question
Format: APA format is recommended (but not required) for this assignment. See Syllabus page for more information on APA format.
The following items will be assessed in particular:
• Relevance (e.g. all content is connected to the question)
• Precision (e.g. specific question is addressed. Statements, facts, and statistics are specific and accurate).
• Depth of discussion (e.g. present and integrate points that lead to deeper issues)
• Breadth (e.g. multiple perspectives and references, multiple issues/factors considered)
• Evidence (e.g. points are well-supported with facts, statistics and references)
• Logic (e.g. presented discussion makes sense, conclusions are logically supported by premises, statements, or factual information)
• Clarity (e.g. writing is concise, understandable, and contains sufficient detail or examples)
• Objectivity (e.g. avoid use of first person and subjective bias)

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Solution Summary

This solution describes key aspects of health care case management.

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Durham regional Hospital case management program: Durham regional Hospital has a highly effective and efficient case management program, which is directed by case management specialists within the organization. The leadership of this case management program is the director of case management, and has subordinate case management personnel located in each of the major health care departments within the organization, such as a case manager that is located within the cardiology department, etc. The case management department also utilizes a mixture of an authoritative and Democratic leadership system, due to the fact that there is a chain of command structure with the director of case management being at the top, and directives are passed down to the senior case manager, who then passes directives on to the case managers within the different departments within the organization. This case management program utilizes the latest information technology equipment in order to maximize the efficiency and effectiveness of the case management activities within the organization. This program also usually receives the budget that is requested by the director of case management, due to the importance of case management within the organization, and the case management program always completes its activities in a high-quality manner within its budgetary constraints. This case management program is instrumental in delivering the best care possible to patients, based on extensive prior planning and ...

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