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  Monday Memo  
 

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Monday, October 22, 2012
  Clinical Accuracy Spoken Here  

Practical Tips for the HCM/UM

Work with the Physicians:

  1. Discuss severity-of-illness issues on a real-time basis at the point of care, from the perspective of the patient and the patient's payer
  2. Avoid mentioning the financial impact on the hospital.
  3. Try using reasoned arguments, accompanied by objective information

Monitor and intervene if necessary regarding:

  1. Medical necessity
  2. Co-existing conditions/Severity of Illness
  3. Potentially avoidable days


  Excellence in Case Mgmt  

UM: CM is Change Agent

As part of their role, hospital case managers (HCMs) serve their organizations as 'change agents' for efficient resource management and advocates for change. In this role, their knowledge of national concerns related to health care must be kept current including:

  • Accreditation
  • Standards
  • Regulatory changes

CMs must remain informed about the influences which, as a direct result of oversight activities, have dramatically changed the entire health care landscape.

[Reference: UM, Module A, Standards and Regulations]
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  Improving Patient Care...  

October: Breast Cancer Awareness
Month: Sister Study

A large, long-term study known as the Sister Study will follow 50,000 women over 10 years whose sisters have had breast cancer. Information will be gathered on many potential breast cancer risk factors. An offshoot, the Two Sister Study, is designed to look at possible causes of early onset breast cancer. [ACS Website; Retrieved 10.3.12. Click here.

[Reference: Women's Health: Module B, Complications]
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Tom RasmussenTom Rasmussen
Publisher
Athena Forum
Tom.Rasmussen@AthenaForum.com

 
 

CALL for RN
Course Reviewers

Athena Forum is now drafting a new online course on Sepsis, and we're looking for RN Case Managers who can spend a few hours reading our draft course for timings and quality comments. Compensation is $150.00. Help us deliver the high quality of courses nurses expect on Athena Forum by being a Piloter of new courses. First come first served. Contact us this week:
Janice Graham, Registrar janiceg@athenforum.com


NEW courses coming in 2012

» Sepsis & LOS

» High Risk OB

» Social Work Ethics

 

 

Cathy WrightCathy Wright, BSN, RN
Clinical Editor
Athena Forum

Cathy.Wright@AthenaForum.com

 

 

Online CE for RN, CCM & LSW
4,000 pages of clinical excellence.

Clinical Excellence® Series
» Asthma
» Behavioral Health
» Colorectal Cancer
» COPD
» CV Risk: Stroke & MI
» Diabetes
» EOL & Palliative Care
» GI Disorders
» Heart Failure
» Multiple Sclerosis
» Obesity Management
» Pain Management
» Rheumatoid Arthritis
» Women's Health
» Wound Care & Payments

CM Excellence® Series

» Principles of Hospital CM
» Patient Advocacy
» Utilization Management
» Discharge Planning
» Hospital Revenue Cycle
» The MCO Continuum Series®

 

 
 

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Tom Rasmussen, Publisher
Tom@AthenaForum.com

Enrollment & passwords
Janice Graham, Registrar
JaniceG@AthenaForum.com

  Monday Memo Archives
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Brease Cancer Awareness Month

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