Eastland Memorial Case Management / Discharge Planning
Case Management / Discharge Planning
Composed of all the healthcare team members, Case Management is a process to help coordinate the care of each individual patient who enters our hospital. Our doctors, nurses and therapists work together to develop a plan that will serve patients through an illness while in the hospital. Discharge Planning then helps the team prepare the patient for the rest of the recovery process once they are released from the hospital.
The team acts as an advocate and allows the patient the opportunity to participate in the plan of care and provide feedback.
The role includes such things as:
Advocacy & Education - ensuring the patient has an advocate for needed services and education.
Clinical Care Coordination - coordinates multiple aspects of care to ensure the patient progresses.
Continuity/Transition - transition of care for the patient from the hospital to the appropriate level of care at home, rehabilitation facility, etc.
Utilization/Financial Management - helps the patient manage resource utilization and reimbursement for services.
Performance and Outcomes Management - measures and if necessary intervenes to achieve desired goals and outcomes for both the hospital and the patient.
Psychosocial Management - addresses psychosocial needs for the patient, family and significant others.