5002 – ED CM: It’s No Longer the Gate, It’s The Front Porch
The need for ED case management has risen greatly in recent times as the role of the ED case manager has evolved. The ED case manager must ensure correct patient status (inpatient, Observation, or to be admitted at all) and manage proper utilization of services. The ED case manager can affect readmission rates and help to identify social determinants that lead to medical issues which lead to high ED utilization. The ED case manager can provide episodic case management by arrange services and connecting the patient with ongoing case management services supporting the goals of the triple aim.
The presentation will compare and contrast 3 models of ED CM programs at 3 local medical centers to illustrate the potential for variances and need to “know your population” when developing an ED CM program.
This presentation demonstrates several case management standards of practice. Standard A, Client selection is demonstrated as the targeted population in the ED consists of defined high utilizers, certain diagnosis along with direct referrals. The case management process is followed as per standards for assessment (B), needs identification (C), and planning (D). Standard H, facilitation coordination and collaboration, is shown as the ED case manager arranges services, makes referrals and works to connect the patient with ongoing case management services through the patient’s insurance plan or hospital-based outpatient services.
1. Explain the need and importance of ED Case Management and define the core functions of case management
2. Evaluate the Goals of ED case management and define the role of the ED Case Manager (ED-CM)
3. Participants will be able to develop a continuity program for chronically critically ill patients using telehealth as a tool between hospitals and post-acute care providers