An embedded case manager in the hospital emergency room is becoming a critical element in a hospital’s case management program. The embedded case manager is the first line of defense in determining medical necessity and can be instrumental in reducing the number of claim denials for a hospital.
Listen to pre-conference comments from Toni Cesta.
During Embedded Case Managers in the Emergency Department, a 60-minute program on now available as a CD-ROM, via On Demand Web access or as a training DVD, Toni Cesta, senior vice president of operational efficiency and capacity management at Lutheran Medical Center, explored how to effectively structure an ED-based case management program and the potential impacts of an embedded case manager in the ED. You will learn:
- How to identify the ED patients that would benefit the most from case management interventions;
- The most effective ways to staff ED case managers and social works;
- The role of the RN case manager and social worker in the ED;
- The clinical and financial benefits of ED case management; and
- Complying with regulatory requirements for ED case management.
With strained hospital budgets, it can be hard to make the business case for a case manager in the ED, but with increasing numbers of claims denials for hospital admissions and RAC audits for the medical necessity of an admission, the ED case manager is integral to a successful hospital case management program.
Don't miss this event to learn the best practices for an ED case management program.
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You can listen to this program right in your office and enjoy significant savings – no travel time or hassle; no hotel expenses. It’s so convenient! Invite your staff members to gather around a conference table to listen to the CD, DVD or the On Demand version.
WHO WILL BENEFIT FROM THIS CONFERENCE?
CEOs, medical directors, disease management directors, managers and coordinators, case management executives, case managers, care management nurses, physician executives and business development and strategic planning directors.
ABOUT OUR PANELISTS:
Toni G. Cesta
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Toni G. Cesta, Ph.D., R.N., F.A.A.N., is senior vice president – operational efficiency and capacity management at
Lutheran Medical Center in Brooklyn, New York. In her position, Dr. Cesta is responsible for case management, social work, discharge
planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation
improvement program and systems process improvement.
Additionally, Dr. Cesta serves as healthcare consultant and partner in Case Management Concepts, LLC, a consulting company
that assists institutions in designing, implementing and evaluating case management models, new documentation systems, and other
strategies for improving care and reducing cost.
Prior to her position as senior vice president at Lutheran Medical Center, Dr. Cesta held positions as vice president for patient flow
optimization at the North Shore – Long Island Jewish Health System and director of case management, Saint Vincents Catholic
Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management
Program and Post-Master’s Certificate Program in case management at Pace University in Pleasantville, New York. Dr. Cesta
completed seven years as a commissioner for the Commission for Case Manager Certification.
Dr. Cesta has been active in the research and development of case management for over 20 years. Her research in case
management has included two funded studies measuring the effects of a case management model on congestive heart failure and
fractured hip patient populations, with measures of patient satisfaction, quality of life, and short and long term clinical perceptions and
outcomes.
Dr. Cesta has presented topics on case management at national and international conferences and workshops. She has
published extensively and the fourth edition of her book, “Nursing Case Management: From Essentials to Advanced Practice
Applications,” Elsevier-Mosby Publishers, was published in 2004. The second edition of her best selling book: “The Case Manager’s
Survival Guide: Winning Strategies for Clinical Practice” was published in 2002 and won the AJN Book of the Year award in 2003.
“Survival Strategies for Nurses in Managed Care” was also released in 2002. Her newest book: “Core Skills for Case Managers” was
published in 2009.
Dr. Cesta is consulting editor of “Hospital Case Management Journal” and “Discharge Planning Advisor.” In addition, she serves as
editorial advisory board member of several case management journals and publications including “Strategies for Healthcare Excellence”
and “The Journal of Care Management.”
Dr. Cesta is a Fellow of the American Academy of Nursing. Her awards include the “Nursing Service Administration Award” from
the New York State Nurses Association, the Jessie M. Scott Award for excellence in research, practice and education from the
American Nurses Association, and three “Book of the Year” awards from the American Journal of Nursing.
Dr. Cesta has a Bachelor of Science in Biology from Wagner College, a Bachelor of Science in Nursing from Adelphi University, a
Master of Arts in Nursing Administration from New York University, and a Doctor of Philosophy in Nursing Research and Theory
Development from New York University.
