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Copyright © 2016 Wolters Kluwer • All Rights Reserved
Chapter 12: Care Management, Case
Management,and Home Healthcare
2Copyright © 2016 Wolters Kluwer • All Rights Reserved
Chapter Highlights
• Defining care management and case management
• Situating case management as a key component of home visiting
• Historical overview and definition of home care practice
• Description of the home care provision
of services
3Copyright © 2016 Wolters Kluwer • All Rights Reserved
Chapter Highlights (cont.)• Examining types of home care agencies,
services, and reimbursement• Exploring role and scope of home care
nursing practice during a home visit• Identifying interdisciplinary roles and use of
telehealth• Describing types of chronic care conditions
found in home care patients• Review of current healthcare reform and
home healthcare delivery
4Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Case management is the development and coordination of care for a selected client and family.
5Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
TrueRationale: Case management—development and coordination of care for a selected client and familyCare management—coordination of a plan or process to bring health services together as a common whole in a cost-effective way
6Copyright © 2016 Wolters Kluwer • All Rights Reserved
Care and Case Management• Care management—coordination of a
plan or process to bring health services together as a common whole in a cost-effective way
• Case management—development and coordination of care for a selected client and family
7Copyright © 2016 Wolters Kluwer • All Rights Reserved
Home Care
• Home care is part of a continuum of care where clients have the opportunity to live and move through the experiences of subacute, chronic, and end-of-life care.
• The care given in home care settings is often managed and directed by a registered nurse.
8Copyright © 2016 Wolters Kluwer • All Rights Reserved
Home Care (cont.)
• Many aspects of the care in both generic and hospice home care are part of a larger care management plan that is individualized using a case management approach.
• The care given in home care settings is interdisciplinary in nature.
9Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Home care is part of a continuum of care where clients have the opportunity to live through the experiences of subacute, chronic, and end-of-life care.
10Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
TrueRationale: Home care is part of a continuum of care where clients have the opportunity to live through the experiences of subacute, chronic, and end-of-life care.
11Copyright © 2016 Wolters Kluwer • All Rights Reserved
• Assessment by collecting data about home care clients
• Diagnosis through the analysis of these data
• Outcome identification that helps home care nurses identify nurse-sensitive measures
Role and Scope of Home Health Practice
12Copyright © 2016 Wolters Kluwer • All Rights Reserved
Role and Scope of Home Health Practice (cont.)
• Planning in the form of nurse-sensitive interventions directed to the identified outcomes
• Implementation-identified nurse-centered actions in collaboration with clients and families
• Evaluation outcome accomplishment through nurse-sensitive interventions
13Copyright © 2016 Wolters Kluwer • All Rights Reserved
Interdisciplinary Care• Various members of the healthcare
team, not just nurses, contribute their expertise to client management in the home.
14Copyright © 2016 Wolters Kluwer • All Rights Reserved
Types of Agencies• Private/voluntary (not-for-profit)• Hospital-based• Proprietary (for-profit)• Official
15Copyright © 2016 Wolters Kluwer • All Rights Reserved
Financing and Regulation of Home Care
– Homebound– Plan of care– Skilled needs– Intermittent care needs– Necessity
16Copyright © 2016 Wolters Kluwer • All Rights Reserved
Home Care Models• Assisted living• Home visits to the homeless• Parish/faith community nursing
17Copyright © 2016 Wolters Kluwer • All Rights Reserved
Home Visit• Initiating the visit• Preparation– Equipment– Directions– Personal safety
18Copyright © 2016 Wolters Kluwer • All Rights Reserved
Home Visit (cont.)• The actual visit– Assessing for risk of medication errors– Assessing for risk of falls– Assessing for risk of abuse and neglect
• Termination of the visit• Postvisit planning
19Copyright © 2016 Wolters Kluwer • All Rights Reserved
Caregivers
• Caregivers are often family members and friends. They must be considered members of the home care team and offered appropriate support if their commitment to care for a loved one at home is to be successful.
20Copyright © 2016 Wolters Kluwer • All Rights Reserved
Nurse–Family Interactions in Home Care
• Culture• Contracts• Confidentiality
21Copyright © 2016 Wolters Kluwer • All Rights Reserved
Question
Is the following statement true or false?Telehealth is a form of electronic communication to deliver chronic care and specialty consultations.
22Copyright © 2016 Wolters Kluwer • All Rights Reserved
Answer
FalseRationale: Telehealth is a form of electronic communication to deliver acute care, not chronic care, and specialty consultations.
23Copyright © 2016 Wolters Kluwer • All Rights Reserved
Telehealth• Telehealth is a form of electronic
communication used to deliver – Acute care and specialty consultations– Home telenursing– Electronic referrals to specialists in expert health
facilities