| This comprehensive resource contains detailed information on how to design and implement a measurement and improvement strategy in case management services. The techniques are applicable to any health care provider or health plan setting. The book includes sample measures, forms, checklists, performance criteria, job descriptions, and other ready-to-use materials.
Table of Contents
How to Use this Handbook
Chapter 1: Care Management Strategic Planning, Measurement and Implementation
Components of the planning process
Step 1: The strategic plan
Common care management strategic goals
Select patient populations
Define objectives
Develop action plans
Step 2: The measurement plan
Measurement systems
Measurement plan for patients with CHF
Baselines
Data collection plan
Feedback system
Step 3: Operationalize the Strategic and Measurement Plans
Chapter 2: Care Management Macro-Level Performance Measures
Types of measurement
Performance measures
Linking objectives and macro-level measures
Are you ready to measure care management performance?
Define patient-specific objectives
Selecting macro-level performance measures
Objectives, action plans and measures for CABG patients
Define measures of success
Measurement principles
Planning for data collection
Chapter 3: Case Management Department Micro-Level Performance Measures
Types of measures
Process measures
Outcome measures
Financial outcome measures
Satisfaction measures
Selecting micro-level performance measures
Identify important tasks
Define measures
Establish acceptable levels of performance
Identify responsible people/groups
Chapter 4: Reporting and Evaluating Performance Data
Types of reports
Macro-level measurement reports
Micro-level measurement reports
Detailed measurement reports
Graphical data displays
Examples of micro-level case management reports
Detailed evaluations of case management performance
Assess and improve case management performance
Use measurement results
Identify needed corrective actions
Common contributing factors in poor performance
Care management performance improvement project
Chapter 5: Measuring and Managing the Performance of Individuals
Management's responsibilities
Defining job competencies
Job analysis
Essential job functions
Written job descriptions
Age-specific competence
Measuring individual performance
Performance evaluation techniques
Measuring age-specific performance
Moving to performance management
Appendix A
Important Case Management Tasks and Relevant Performance Measures
Appendix B
Sample Case Manager Job Descriptions
Appendix C
Strategic Planning and Performance Measurement Forms |
