Case Management

Case Management has become one of the most effective means by which a continuum of care functions effectively and efficiently, and Murer Consultants has been an advocate of centralized case management for more than fifteen years. The Case Management Workbook: Defining the Role of Physicians, Nurses, and Case Managers, which is a complete examination of the application of continuum of care, defines the roles of the case management team and provides an overview of key post-acute venues of care. The firm’s first book on case management, The Case Management Sourcebook, dealt with auditing existing models implementing a centralized case management system, whether for a single hospital or an entire health system.

The authors demonstrate that the case management team includes many more individuals than simply those with the title of case manager. The team must consist of key clinical personnel including the nurse, the physician and the case manager, each of whom have a specific roles. Their newest book also highlights the role administration plays in assuring each member of the team is on board with the hospital’s or health system’s goal in assuring the patient is at the right place at the right time in their episode of care. It supplies an overview of the process, its structure, and the responsibility of each member of the team. Whether conducting training for actual case managers or orientation for physicians, nurses, senior administrators, and/or Boards of Directors, Murer Consultants has been effective in their training of all these people using a six-month ongoing education curriculum specifically developed for the institution or system. The key elements of case management stressed include:

Situational audit to identify current status of existing post-acute venue options
Identification of opportunities to enhance the infrastructure of the continuum of care
Development of a hospital profile to identify financial vulnerabilities resulting in lack of availability, or optimal utilization of post-acute venues to minimize the financial burden on the hospital for patients remaining in the acute bed beyond the DRG mean length of stay
Consensus determination as to the scope of case management based on identification of diseases/venue management and payor mix structuring for management of capitated/risk patients
Education and training of identified case management staff to assure uniformity of knowledge and expertise
Interviews and interaction with medical staff, through multiple informal orientation sessions to identify and address physician concerns and suggestions as well as to assure accurate and consistent information as to implementation of a case management system

A number of important regulatory changes have occurred in the past 13 years, since the original book was published and there is now a new landscape of healthcare reform. As with the 1997 publication, Murer Consultants believes this book will serve as an important resource for anyone dealing with case management.

Case Management training program developed by Murer Consultants.
For the syllabus schedule, please click here.
For the program schedule, please click here.

The Case Management Workbook, Productivity Press, 2011
The Case Management Sourcebook, McGraw Hill, 1997