5 Critical Aspects for Successful CAT Case Management

Posted by on Dec 14, 2011 in Blog, Case Management, Nursing, Workers Compensation

Acknowledging that each individual case is different within its specific merits, some critical commonalities exist regarding the successful management of any catastrophic case. These commonalities include the perspective of healthcare providers and their associated facilities, as well as the perspectives of the individual patient and his or her family. A catastrophic Nurse Case Manager is a key player in helping to successfully manage a catastrophic injured patient/worker. Costs  Cost represents the pinnacle concern and the top influencing factor in patient care — not just the costs incurred by the health care organization, the associated health care professionals and administrative staff, but also the costs for the patient as well (unless the injury is work related). While patients are obviously thankful for receiving quality healthcare, the doctors, nurses, staff members and other providers — and even any equipment present — all look like dollar signs when viewed through the eyes of the attorney, insurance adjustor, and patient, or their family. It is easier for the health care provider to see and understand the needed costs and long-term benefits of care. Patients, their advocates, and non-medical participants find seeing these benefits more difficult. Providers must manage costs carefully, keeping in mind the importance of the cost-benefit relationship. Communication  By communicating these benefits effectively with the patient and his or her advocates, the physician increases patient compliance with the long-term recommendations. This transparency also builds confidence among insurance adjustors, attorneys, and other patient advocates regarding the quality and appropriateness of the provided healthcare strategy. WWW.CIARAGERAGHTY.COM/WP-CONTENT/UPLOADS/2011/09/1/payday cash todaynon broker payday loans This communication must bear a tone and quality that the patient, and his or her advocates, can readily understand. Providers that lack proper bedside manner, or the ability to convey the relevance and appropriateness of care, almost guarantee that the patient and patient advocates will balk at the recommended long-term care strategy. This is especially true when high dollar strategies are requested for extended periods of time or for chronic problems/conditions. For successful management of the catastrophic case, the patient and all involved advocates must have full disclosure regarding all aspects of the case involving their health, treatment plans and recovery — from start to finish. Availability and Caring Patients and their representatives greatly benefit by participating in transparent communication between the attending staff and other caregivers. Transparent communication refers to the availability of staff to competently answer questions and address concerns in a suitable, satisfactory way and in a timely manner. This transparency and availability of staff to offer support that proves transparency of care, quells many fears, foments compliance, and creates an environment of caring. Patients know that they are being cared for, but do they know that anyone cares?...

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To Clot or Not?

Posted by on Jan 6, 2011 in Blog, Case Management, LNC, Nursing, RN

Over my many years as a RN I have had multiple patients on anticoagulation medications.  As a result I am very comfortable in administering the medications as prescribed by physicians. In addition, I have worked on cases involving anticoagulation both as a Case Manager and a LNC, yet the complications and dangers of working with such medications cannot be stated enough or go underemphasized. In all of these roles, there are some cardinal rules- Extreme care with ALL aspects of dosing/administration Regular medical follow up Careful blood level monitoring (PT/INR) Thorough patient/family education I recently read a blog post detailing information about anticoagulation, potential problems/complications and improvements within the medical arena.  Areas like patient education, pharmacy/pharmacist involvement, patient compliance, new delivery systems and overall management improvements are being addressed throughout the medical communities- all of which are improving patient quality and continuing to help save lives.   Highlights: An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting Anticoagulants are administered in oral or parenteral (injection) forms. Examples heparin, Coumadin (warfarin)  Anticoagulation medicines play a huge role in clinical medicine and help to save lives on a daily basis. Close management of the medications is necessary, and mistakes involving too much or too little medication can lead to severe complications. Law suits involving anticoagulation issues are fairly common. Other medications (i.e. aspirin) and/or food (dark green vegetables) have anticoagulation properties, so potential drug interactions must be identified and/or monitored. Anticoagulation is literally a LIFESAVER, but it also carriers with it severe and sometimes deadly complications that are associated with too much OR too little medication.  Better things are on the horizon, but caution when using/taking the medications still...

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What Am I?

Posted by on Nov 17, 2010 in Blog, Kari Williamson, Legal Nurse Consultant, LNC, MK Consulting, MKC, Nursing, RN

What Am I?   I am reviewer of records…all kinds of medical records from all kinds of providers. I am registered nurse with additional education in the legal field. amercially reasonable mannersame day loans bad credit no fees I have YEARS of being an active nurse provider in the clinical, insurance and legal arenas I know medical terminology, and can read and understand an operative report. I create medical summaries and chronologies. I help with causality issues and injury-medical relatedness questions. I search for medical/nurse experts across the country. I analyze medical records and documentation. I consult with adjusters and attorneys about liability issues. I use critical thinking and knowledge to help resolve claims and file issues.   I read and write reports….ALOT I do medical literature research I have to know and understand the insurance legal arenas …and the list goes on. What am I? A seasoned Legal Nurse...

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