An ideal reference guide for case managers who work with complex, multimorbid patients, The Integrated Case Management Manual helps readers enhance their ability to work with these patients, learn how to apply new evidence-based assessments, and advocate for improved quality and safe care for all patients. This text encourages case managers to assess patients with both medical and mental health barriers to improvement in order to coordinate appropriate integrated health interventions and treatment planning.

Built upon the goals and values of the Case Management Society of America (CMSA), this manual guides case managers through the process of developing new and important cross-disciplinary skills. These skills will allow them to alter the health trajectory of some of the neediest patients in the health care system. Key Features:

Tools and resources for deploying an Integrated Health Model (physical and mental health treatment) to the medically complex patient
Complexity assessment grids: a color-coded tool for tracking patient progress and outcomes throughout the trajectory of the illness
Methods for building collaborative partnerships in emerging models of care delivery within multidisciplinary health care teams
Strategies for using an integrated case management approach to improve efficiency, effectiveness, accountability, and positive outcomes in clinical settings
Guidance on connecting multi-disciplinary teams to assist with health issues in the biological, psychological, and social domains to overcome treatment resistance, reduce complications, and reduce cost of care

Contenu

"Foreword
Preface
Acknowledgments
Overview
Introduction
CHAPTER 1 Case Management, Integrated Case Management, and Complexity Assessment Grids
CHAPTER 2 Overview of Health Complexity and the Interaction Between Physical Health and Mental Conditions
CHAPTER 3 The Organization of Integrated Case Management Environments and Work Processes
CHAPTER 4 Motivational Interviewing and Health Behavior Change in Complex Patients With contributions by Jos Dobber, MSc
CHAPTER 5 Cross-Disciplinary Training for Integrated Case Managers
CHAPTER 6 Examples of Basic Information on Common Physical and Mental Conditions
CHAPTER 7 Adult Integrated Case Management Using INTERMED Complexity Assessment Grid Methodology
CHAPTER 8 Child/Youth Integrated Case Management Using Pediatric
INTERMED-Complexity Assessment Grid Methodology
CHAPTER 9 Interpreting Complexity Assessment Grid Anchor Point Scores
CHAPTER 10 Using a Case ManagerñPatient Dialogue for Complexity Assessment and Care Plan Development
CHAPTER 11 Managing Adult and Pediatric Cases Using Integrated Case Management
CHAPTER 12 Assisting Lucinda: Depressed Diabetic Patient With Numerous Complications, Poor Control, and High Service Use
CHAPTER 13 Assisting Robert: Disabled Employee With Chronic Lung Disease, Panic Att acks, and Alcohol Abuse
CHAPTER 14 Assisting Paul: Thirteen-Year-Old With Congenital Heart Disease, Family Anxiety, and School Nonatt endance
Appendices
Case Management Flowcharts
APPENDIX 1A: Integrated Case Management Team Formation and Training
APPENDIX 1B: Cross-Disciplinary Integrated Case Manager Training
APPENDIX 1C: Integrated Case Manager Care Plan: Triggering and Triage
APPENDIX 1D: Integrated Case Management Checklist
APPENDIX 1E: Integrated Case Manager Care Plan: Initial and Iterative
Intervention
APPENDIX 1F: Integrated Case Manager Care Plan: Progression Review
APPENDIX 1G: Integrated Case Manager Care Plan: Discharge
Triaging and Informed Consent Tools
APPENDIX 2: Triage Guidelines with Examples of Case Management Triggers
APPENDIX 3: Universal Consent Form
INTERMED-Complexity Assessment Grid's
APPENDIX 4: IM-CAG Scoring Sheet
APPENDIX 5: PIM-CAG Scoring Sheet
APPENDIX 6: IM-CAG Complexity Items and Anchor Points
APPENDIX 7: PIM-CAG Complexity Items and Anchor Points
APPENDIX 8: Activities Associated With IM-CAG Scores
APPENDIX 9: Activities Associated With PIM-CAG Scores
Templates for Care Plan Development and Outcome Measurement
APPENDIX 10: Care Plan Development (CD)
APPENDIX 11: Record of Outcome Measures (ROM)
APPENDIX 12: Measurement of Progress (MP3)
Abbreviations and TerminologyAPPENDIX 13: Abbreviations
APPENDIX 14: Defi nition of Terms European INTERMED in English
APPENDIX 15: European INTERMED in English: IM-CAG v6
Appendices Available on Springer Website
APPENDIX A: Stratifi cation and Prioritization of Triggered Complex Case Management Candidates
APPENDIX B: Case Management Candidate Induction Templates
APPENDIX C: Potential Content for a Case Management Brochure
APPENDIX D: Notifi cation Lett er to Patientís Clinician(s)
APPENDIX E: Scripted Questions: Integrated Case Management Assessment for Adults
APPENDIX F: Scripted Questions: Integrated Case Management Assessment for Children/Youth
Index "