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The American Case Management Association (ACMA), a non-profit association dedicated to the support and development of the profession of case management through educational forums, networking opportunities, legislative advocacy and establishing the industry's Standards of Practice, [2] defines case management as: [3]
Medical case management is a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals. It is a role frequently overseen by patient advocates .
Case management (US health system), a specific term used in the health care system of the United States of America; Medical case management, a general term referring to the facilitation of treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals; Legal case management, a set of management ...
A nurse operating medical equipment in an ambulatory care setting. Ambulatory care services typically consist of a multidisciplinary team of health professionals that may include (but is not limited to) physicians, nurse practitioners, nurses, pharmacists, occupational therapists, physical therapists, speech therapists, and other allied health professionals.
Process denotes the transactions between patients and providers throughout the delivery of healthcare. Finally, outcomes refer to the effects of healthcare on the health status of patients and populations. [2] Avedis Donabedian, a physician and health services researcher at the University of Michigan, developed the original model in 1966. [3]
A clinical pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or visit (homecare).
The case management restrictions must not "substantially impair access" to primary care services of "adequate quality where medically necessary"; and; The case management restrictions must be "cost effective". [2] In their earliest forms, PCCM programs closely resembled traditional fee-for-service Medicaid than managed care.
The model was developed by Dr. Kathleen Stevens at the Academic Center for Evidence-Based Practice located at the University of Texas Health Science Center at San Antonio. [3] The model has been represented in many nursing textbooks , used as part of an intervention to increase EBP competencies, and as a framework for instruments measuring EBP ...