C Schraeder
John Wiley & Sons
e druk, 2011
9780813811949
Comprehensive Care Coordination
Specificaties
Paperback, 480 blz.
|
Engels
John Wiley & Sons |
e druk, 2011
ISBN13: 9780813811949
Rubricering
Levertijd ongeveer 15 werkdagen
Samenvatting
Breakthroughs in medical science and technology, combined with shifts in lifestyle and demographics, have resulted in a rapid rise in the number of individuals living with one or more chronic illnesses.
Comprehensive Care Coordination for Chronically Ill Adults presents thorough demographics on this growing sector, describes models for change, reviews current literature and examines various outcomes.
Comprehensive Care Coordination for Chronically Ill Adults is divided into two parts. The first provides thorough discussion and background on theoretical concepts of care, including a complete profile of current demographics and chapters on current models of care, intervention components, evaluation methods, health information technology, financing, and educating an interdisciplinary team. The second part of the book uses multiple case studies from various settings to illustrate successful comprehensive care coordination in practice. Nurse, physician and social work leaders in community health, primary care, education and research, and health policy makers will find this book essential among resources to improve care for the chronically ill.
Specificaties
Inhoudsopgave
<p>Editors and Contributors ix</p>
<p>Acknowledgments xv</p>
<p>Introduction xvii</p>
<p>PART 1 THEORETICAL CONCEPTS</p>
<p>1 Chronic illness 3<br />Paul Shelton, EdD, Cheryl Schraeder, RN, PhD, FAAN, Michael K. Berkes, BS, MSW Candidate, and Benjamin Ronk, BA</p>
<p>2 Overview 25<br />Cheryl Schraeder, RN, PhD, FAAN, Paul Shelton, EdD, Linda Fahey, RN, MSN, Krista L. Jones, DNP, MSN, ACHN, RN, and Carrie Berger, BA, MSW Candidate</p>
<p>3 Promising practices in acute/primary care 39<br />Randall S. Brown, PhD, Arkadipta Ghosh, PhD, Cheryl Schraeder, RN, PhD, FAAN, and Paul Shelton, EdD</p>
<p>4 Promising practices in integrated care 65<br />Patricia J. Volland, MSW, MBA, and Mary E. Wright</p>
<p>5 Intervention components 87<br />Cheryl Schraeder, RN, PhD, FAAN, Cherie P. Brunker, MD, Ida Hess, MSN, FNP–BC, Beth A. Hale, PhD, RN, Carrie Berger, BA, MSW Candidate, and Valerie Waldschmidt, BSE</p>
<p>6 Evaluation methods 127<br />Robert Newcomer, PhD, and L. Gail Dobell, PhD</p>
<p>7 Health information technology 141<br />David A. Dorr, MD, MS and Molly M. King, BA</p>
<p>8 Financing and payment 167<br />Julianne R. Howell, PhD, Robert Berenson, MD, and Patricia J. Volland, MSW, MBA</p>
<p>9 Education of the interdisciplinary team 191<br />Emma Barker, MSW, Patricia J. Volland, MSW, MBA, and Mary E. Wright</p>
<p>PART 2 PROMISING PRACTICES</p>
<p>SECTION 1 PRIMARY CARE MODELS</p>
<p>10 Coordination of care by guided care interdisciplinary teams 209<br />Chad Boult, MD, MPH, MBA, Carol Groves, RN, MPA, and Tracy Novak, MHS</p>
<p>11 Care management plus 221<br />Cherie P. Brunker, MD, David A. Dorr, MD, MS, and Adam B. Wilcox, PhD</p>
<p>12 Medicare coordinated care 229<br />Angela M. Gerolamo, PhD, APRN, BC, Jennifer Schore, MSW, MS, Randall S. Brown, PhD, and Cheryl Schraeder, RN, PhD, FAAN</p>
<p>SECTION 2 TRANSITIONAL CARE MODELS</p>
<p>13 The care transitions intervention 263<br />Susan Rosenbek, RN, MS, and Eric A. Coleman, MD, MPH</p>
<p>14 Enhanced Discharge Planning Program at Rush University Medical Center 277<br />Anthony J. Perry, MD, Robyn L. Golden, LCSW, Madeleine Rooney, MSW, LCSW, and Gayle E. Shier, MSW</p>
<p>SECTION 3 INTEGRATED MODELS</p>
<p>15 Summa Health System and Area Agency on Aging Geriatric Evaluation Project 293<br />Kyle R. Allen, DO, AGFS, Joseph L. Ruby, BA, MA, Susan Hazelett, RN, MS, Carolyn Holder, MSN, RN, GCNS–BC, Sandee Ferguson, RN, BBA, MS, Fellow, and Phyllis Yoders, RN, BSN</p>
<p>16 Program of All–Inclusive Care for the Elderly (PACE) 303<br />Brenda Sulick, PhD, and Christine van Reenen, PhD</p>
<p>SECTION 4 MEDICAID MODELS</p>
<p>17 Introduction to Medicaid care management 317<br />Allison Hamblin, MSPH, and Stephen A. Somers, PhD</p>
<p>18 The Aetna Integrated Care Management Model: a managed Medicaid paradigm 325<br />Robert M. Atkins, MD, MPH, and Mark E. Douglas, JD, MSN, RN</p>
<p>19 King County Care Partners: a community based chronic care management system for Medicaid clients with co–occurring medical, mental, and substance abuse disorders 339<br />Daniel S. Lessler, MD, MHA, Antoinette Krupski, PhD, and Meg Cristofalo, MSW, MPA</p>
<p>20 Predictive Risk Intelligence SysteM (PRISM): a decision–support tool for coordinating care for complex Medicaid clients 349<br />Beverly J. Court, MHA, PhD, David Mancuso, PhD, Chad Zhu, MS, and Antoinette Krupski, PhD</p>
<p>21 High–risk patients in a complex health system: coordinating and managing care 361<br />Maria C. Raven, MD, MPH, MSc</p>
<p>22 The SoonerCare Health Management Program 371<br />Carolyn J. Reconnu, RN, BSN, CCM, and Mike Herndon, DO</p>
<p>SECTION 5 PRACTICE CHANGE</p>
<p>23 Introduction: practice change fellows initiatives 379<br />Eric A. Coleman, MD, MPH, and Nancy Whitelaw, PhD</p>
<p>24 Interdisciplinary care of chronically ill adults: communities of care for people living with congestive heart failure in the rural setting 383<br />Lee Greer, MD, MBA</p>
<p>25 Collaborative care treatment of late–life depression: development of a depression support service 391<br />Eran D. Metzger, MD</p>
<p>26 Geriatric Telemedicine: supporting interdisciplinary care 407<br />Daniel A. Reece, MSW, LCSW</p>
<p>27 Integrated Patient–Centered Care: the I–PiCC pilot 417<br />Karyn Rizzo, RN, CHPN, GCNS</p>
<p>SECTION 6 MEDICARE MANAGED CARE</p>
<p>28 Longitudinal care management: High risk care management 431<br />Chandra L. Torgerson, RN, BSN, MS, and Lynda Hedstrom, MSN, APRN, NP–C</p>
<p>SECTION 7 INTERNATIONAL CARE COORDINATION</p>
<p>29 The experiences in the Republic of Korea 441<br />Weon–seob Yoo, PhD, MPH, MD, and Joo–bong Park Oh, MN, MS, PsyD, RN</p>
<p>Index 451</p>
<p>Acknowledgments xv</p>
<p>Introduction xvii</p>
<p>PART 1 THEORETICAL CONCEPTS</p>
<p>1 Chronic illness 3<br />Paul Shelton, EdD, Cheryl Schraeder, RN, PhD, FAAN, Michael K. Berkes, BS, MSW Candidate, and Benjamin Ronk, BA</p>
<p>2 Overview 25<br />Cheryl Schraeder, RN, PhD, FAAN, Paul Shelton, EdD, Linda Fahey, RN, MSN, Krista L. Jones, DNP, MSN, ACHN, RN, and Carrie Berger, BA, MSW Candidate</p>
<p>3 Promising practices in acute/primary care 39<br />Randall S. Brown, PhD, Arkadipta Ghosh, PhD, Cheryl Schraeder, RN, PhD, FAAN, and Paul Shelton, EdD</p>
<p>4 Promising practices in integrated care 65<br />Patricia J. Volland, MSW, MBA, and Mary E. Wright</p>
<p>5 Intervention components 87<br />Cheryl Schraeder, RN, PhD, FAAN, Cherie P. Brunker, MD, Ida Hess, MSN, FNP–BC, Beth A. Hale, PhD, RN, Carrie Berger, BA, MSW Candidate, and Valerie Waldschmidt, BSE</p>
<p>6 Evaluation methods 127<br />Robert Newcomer, PhD, and L. Gail Dobell, PhD</p>
<p>7 Health information technology 141<br />David A. Dorr, MD, MS and Molly M. King, BA</p>
<p>8 Financing and payment 167<br />Julianne R. Howell, PhD, Robert Berenson, MD, and Patricia J. Volland, MSW, MBA</p>
<p>9 Education of the interdisciplinary team 191<br />Emma Barker, MSW, Patricia J. Volland, MSW, MBA, and Mary E. Wright</p>
<p>PART 2 PROMISING PRACTICES</p>
<p>SECTION 1 PRIMARY CARE MODELS</p>
<p>10 Coordination of care by guided care interdisciplinary teams 209<br />Chad Boult, MD, MPH, MBA, Carol Groves, RN, MPA, and Tracy Novak, MHS</p>
<p>11 Care management plus 221<br />Cherie P. Brunker, MD, David A. Dorr, MD, MS, and Adam B. Wilcox, PhD</p>
<p>12 Medicare coordinated care 229<br />Angela M. Gerolamo, PhD, APRN, BC, Jennifer Schore, MSW, MS, Randall S. Brown, PhD, and Cheryl Schraeder, RN, PhD, FAAN</p>
<p>SECTION 2 TRANSITIONAL CARE MODELS</p>
<p>13 The care transitions intervention 263<br />Susan Rosenbek, RN, MS, and Eric A. Coleman, MD, MPH</p>
<p>14 Enhanced Discharge Planning Program at Rush University Medical Center 277<br />Anthony J. Perry, MD, Robyn L. Golden, LCSW, Madeleine Rooney, MSW, LCSW, and Gayle E. Shier, MSW</p>
<p>SECTION 3 INTEGRATED MODELS</p>
<p>15 Summa Health System and Area Agency on Aging Geriatric Evaluation Project 293<br />Kyle R. Allen, DO, AGFS, Joseph L. Ruby, BA, MA, Susan Hazelett, RN, MS, Carolyn Holder, MSN, RN, GCNS–BC, Sandee Ferguson, RN, BBA, MS, Fellow, and Phyllis Yoders, RN, BSN</p>
<p>16 Program of All–Inclusive Care for the Elderly (PACE) 303<br />Brenda Sulick, PhD, and Christine van Reenen, PhD</p>
<p>SECTION 4 MEDICAID MODELS</p>
<p>17 Introduction to Medicaid care management 317<br />Allison Hamblin, MSPH, and Stephen A. Somers, PhD</p>
<p>18 The Aetna Integrated Care Management Model: a managed Medicaid paradigm 325<br />Robert M. Atkins, MD, MPH, and Mark E. Douglas, JD, MSN, RN</p>
<p>19 King County Care Partners: a community based chronic care management system for Medicaid clients with co–occurring medical, mental, and substance abuse disorders 339<br />Daniel S. Lessler, MD, MHA, Antoinette Krupski, PhD, and Meg Cristofalo, MSW, MPA</p>
<p>20 Predictive Risk Intelligence SysteM (PRISM): a decision–support tool for coordinating care for complex Medicaid clients 349<br />Beverly J. Court, MHA, PhD, David Mancuso, PhD, Chad Zhu, MS, and Antoinette Krupski, PhD</p>
<p>21 High–risk patients in a complex health system: coordinating and managing care 361<br />Maria C. Raven, MD, MPH, MSc</p>
<p>22 The SoonerCare Health Management Program 371<br />Carolyn J. Reconnu, RN, BSN, CCM, and Mike Herndon, DO</p>
<p>SECTION 5 PRACTICE CHANGE</p>
<p>23 Introduction: practice change fellows initiatives 379<br />Eric A. Coleman, MD, MPH, and Nancy Whitelaw, PhD</p>
<p>24 Interdisciplinary care of chronically ill adults: communities of care for people living with congestive heart failure in the rural setting 383<br />Lee Greer, MD, MBA</p>
<p>25 Collaborative care treatment of late–life depression: development of a depression support service 391<br />Eran D. Metzger, MD</p>
<p>26 Geriatric Telemedicine: supporting interdisciplinary care 407<br />Daniel A. Reece, MSW, LCSW</p>
<p>27 Integrated Patient–Centered Care: the I–PiCC pilot 417<br />Karyn Rizzo, RN, CHPN, GCNS</p>
<p>SECTION 6 MEDICARE MANAGED CARE</p>
<p>28 Longitudinal care management: High risk care management 431<br />Chandra L. Torgerson, RN, BSN, MS, and Lynda Hedstrom, MSN, APRN, NP–C</p>
<p>SECTION 7 INTERNATIONAL CARE COORDINATION</p>
<p>29 The experiences in the Republic of Korea 441<br />Weon–seob Yoo, PhD, MPH, MD, and Joo–bong Park Oh, MN, MS, PsyD, RN</p>
<p>Index 451</p>