Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results Sharon Mass, PhD, LCSW, ACM; Donna Ukanowicz, MS, RN, ACM; Mark S. Michelman, MD, MBA
As of June 20, 2014, contact hours for nurses are no longer available with this product.
Foster effective relationships between case management and physicians with a strong physician advisor program.
With increasing federal compliance regulations, there has never been a greater need to have a physician advisor (PA) on staff to provide your case management team with more support to achieve your organizational goals.
Whether you're building a new PA program or want to revitalize an existing one, the new HCPro book Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results delivers the guidance you need to improve the chain of communication across the continuum of care.
Written by Mark Michelman, MD, MBA, Sharon Mass, PhD, LCSW, ACM, and Donna Ukanowicz, MS, RN, ACM, the book combines the perspectives of a physician advisor, nursing case manager, and social work case manager. The book is the industry's first resource that provides:
- Easy-to-follow steps to create or revamp your program
- Tips to recruit and train PAs
- Strategies for defining measurable goals and effective PA responsibilities
- Analysis methods for evaluating need and justifying resources
- Metrics to measure your success
- A CD-ROM loaded with adaptable tools and forms
This book will teach you to define and shape a program that improves utilization management and compliance, and it provides solutions and strategies to help your organization:
- Make correct admission decisions and streamline discharge planning
- Understand observation status and maximize reimbursement
- Prevent denials and effectively reverse decisions
- Improve resource utilization
- Focus on clinical documentation improvement
- Target quality improvement efforts
- Strengthen communication across the continuum of care
- Educate physicians and case managers
- Track, trend, and resolve outlier information
Table of ContentsChapter 1: Case Management and Physician Advisors
Chapter 2: Assessing the Need for Physician Advisors
Chapter 3: The Role of Physician Advisors
Chapter 4: Selecting a Physician Advisor Model
Chapter 5: How Physician Advisors and Case Managers Can Work Together
Chapter 6: Choosing and Hiring the Right Physician Advisor
Chapter 7: Training and Orientation
Chapter 8: Revitalizing Existing Programs
Chapter 9: Outcomes
Learning objectivesIdentify the types of case management models
Discuss the various roles and responsibilities of case managers
Describe why conflict can occur between physicians and case managers
Discuss how case management physician advisors can support case managers
Identify the types of case management models
Discuss where PAs can fit in different case management models
Assess the need for a PA
Discuss strategies to secure buy-in from medical staff, administration, case management, and nursing
Discuss the role played by PAs
Examine how PA roles interact with case management
List the five main types of PAs
Determine ways to choose the best PA model for an organization
Explain how PAs and case management can work together
Determine ways case managers and PAs can influence organizational objectives
Understand potential sources of conflict with PAs
Explain criteria for choosing PA candidates
Identify whether the organization has a potential PA candidate
Evaluate the merits of internal PAs versus outsourced candidates
Discuss ways to determine whether the organization needs a full or part-time position
Explain training best practices for new PAs
Determine the director of case management's role in orienting PAs
Discuss strategies for revitalizing an ineffective PA program
Identify how to set expectations for a PA program
Discuss ways to track and trend data
Evaluate data to determine outcomes of PA program
If you are contemplating a physician advisor for your hospital, ever wondered how a physician advisor would benefit your organization, or need guidance in establishing such a position, then this book is just what you need. Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results provides wealth of information on the possible roles, duties, and models of a physician advisor. Full of practical tips and advice, Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results fills a visible void in the case management literature of the potential roles and benefits of dedicated physician involvement.
- Gail P. Grant, MD, MPH, MBA
