Instructor:
Toni Cesta
Product ID: 705424
Why Should You Attend:
No hospital can afford to remain stagnant in an environment that seems to be changing at a lightening pace. While the Medicare programs had remained fairly constant for many years, CMS now routinely changes the penalty and reimbursement structure in addition to adding new expectations such as the Two-Midnight Rule, and other similar rules and measures. Nevertheless it seems that the case management department often seems to be the last department to be up-dated or enhanced to meet the new challenges imposed by the Affordable Care Act and Value-Based Purchasing.
Whether introduced in the inpatient, outpatient, or any other setting across the continuum of care, case management models can be adapted to meet the goals of quality patient care in a fiscally responsible manner. Selection of the most appropriate model will depend on the needs of the organization, the available resources, and the expected goals and outcomes.
This webinar will review contemporary, best practice, case management models. This will be followed by the pros and cons of each model and how the department might be designed to accommodate each model. The best practice staffing rations for each model will be discussed as they apply to the roles of the RN case manager and the social worker as well as strategies for optimizing existing resources.
This webinar will also provide you with the tools that you will need to identify the changes or upgrades you may need to make in your own case management department.
Areas Covered in the Webinar:
Who Will Benefit:
Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, new documentation systems, and other strategies for improving care and reducing cost. The author of nine books, and a frequently sought after speaker, lecturer and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.
Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.
Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program and systems process improvement. Prior to her position as Senior Vice President at Lutheran Medical Center, Dr. Cesta has held positions as Corporate Vice President for Patient Flow Optimization at the North Shore – Long Island Jewish Health System and Director of Case Management, Saint Vincents Catholic Medical Centers of New York, in New York City and also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.
Dr. Cesta has been active in the research and development of case management for over 25 years. Her research in case management has included two funded studies measuring the effects of a case management model on congestive heart failure and fractured hip patient populations, with measures of patient satisfaction, quality of life, and short and long term clinical perceptions and outcomes.
Dr. Cesta has presented topics on case management at national and international conferences and workshops. Her books include “Nursing Case Management: From Essentials to Advanced Practice Applications”, “The Case Manager’s Survival Guide: Winning Strategies in the New Healthcare Environment”, “The Case Manager’s Survival Guide: Winning Strategies for Clinical Practice”, “Survival Strategies for Nurses in Managed Care” and “Core Skills for Hospital Case Managers”. Dr. Cesta is Consulting Editor of “Hospital Case Management Journal” and “Discharge Planning Advisor”. In addition, she serves as editorial advisory board member of several case management journals and publications including “Strategies for Healthcare Excellence” and “The Journal of Care Management”.
Dr. Cesta has a BS in Biology from Wagner College, a BS in Nursing from Adelphi University, an MA in Nursing Administration from New York University, and a Ph.D. in Nursing Research and Theory Development from New York University.
Dr. Cesta is a Fellow of the American Academy of Nursing. Among her awards are included the “Nursing Service Administration Award” from the New York State Nurses Association, the Jessie M. Scott Award for excellence in research, practice and education from the American Nurses Association, and three “Book of the Year” awards from the American Journal of Nursing. In 2010, she was awarded the Brooklyn Leaders Award from the Arthritis Foundation.
Topic Background:
The Centers for Medicare and Medicaid Services (CMS) has instituted linkages between cost and quality through value-based purchasing and other cost-saving measures such as payment penalties for high readmission rates. These changes have created the first links between the cost and quality of health care. These factors now require that case management models begin to change and adapt. The early case management models no longer meet the needs of the changing healthcare landscape. It is for this main reason that hospitals and health care systems must look thoughtfully and carefully at the design of their case management models, and staffing ratios of their case management departments.
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