Put an End to Missed Opportunities.

The ongoing transformation of America's health care system is bringing disruption in every sector of our industry. Hospital case management programs are similarly undergoing dramatic changes as care coordination for our most vulnerable patients becomes the focus of many hospital case management programs. As a result, case management leaders and human resource directors are disrupting legacy assumptions and expanding eligibility for the role of the hospital case manager.

Changes in hospital case management through the years.

"Going Forward: What Is Case Management?," a recent HeartBeat of Case Management column in this journal, set off a wave of positive comments to the author. Hospital case management has been at the forefront of many of the changes in the past several decades. Even today, these changes should be reevaluated to enhance what is best for the patient, the business of health care, quality, and evidence-based care.

Hospital case management and progression of care.

Progression of care refers to a three-pronged approach to managing the complexities of the fragmented care delivery that is commonplace in U.S. healthcare systems.

Introducing HCM v3.0: a standard model for hospital case management practice.

Purpose/objectives: Like the professional definitions of case management, the practice of hospital management is a dynamic process. However, because hospital case management programs come in so many shapes and sizes, there is a widespread tendency to forego the process and instead focus on the static tasks associated with utilization review and discharge plan arrangements. As a result, the research identifying best practices is inhibited and hospital case management practice is constrained.

Faster than a speeding bullet: changes in medicare rules for the hospital case manager.

Purpose/objectives: Compliance with the various Centers for Medicare & Medicaid Services rules and regulations is rapidly becoming a challenge in hospitals as the frequency and complexity of the new mandates have increased. Although compliance officers may oversee major elements emanating from the regulatory agencies, practical application during routine work activities requires current information and peer-to-peer reinforcement. This article addresses some of the more recent changes-or proposed changes-that may impact hospital case management practice and the case managers' role as patient advocate.

Hospitalists and case managers: the perfect partnership.

Part of every hospital case manager's strategic advocacy is the promotion of a consistent partnership with the patient's primary clinical player. The presence of hospitalists, a new and growing specialty, offers the case manager an opportunity to advance that partnership. Instead of having to wait for a doctor whose practice is outside the hospital to review a test result or order a procedure, hospitalists can do the same thing faster--leading to greater efficiency, better care, and shorter stays for patients.