Case Manager Certification Exam(Answered)

Case Manager Certification Exam(Answered) case management the dynamic and systematic collaborative approach to providing and coordinating health care services to a defined population. - participative process to identify and facility options and services for meeting individual healthcare needs while decreasing fragmentation and duplication of care and increasing quality and cost effective clinical outcomes. standards of care parameters to measure the quality of healthcare clinical guidelines statements to help make decisions about health specific circumstances. clinical pathway structured multi-disciplined plan of care to support clinical guidelines and protocol to improve continuity and coordination. 4 parts of clinical pathway 1. timeline 2. categories of care/activities and interventions 3. intermediate and long term outcome criteria 4. variance tracking are 4 parts of what? decision tree used to select the best course of action in decisions where there is no clear decisions. descriptive screening tool identifies characteristics about a population to show health prevention. predictive screening tool shows what may happen to a specific population. evaluative screening tool evaluates the understanding/effectiveness SF-36 predictive screening tool to assess functional health and well being. Assesses physical and mental health. - used in health economics, cost-effectiveness of health tx -evals individual patient health status. - does not consider sleep -scored 00-100, lower score- incr. disability patient activation measure 13 item predictive screening tool to evaluate patient's knowledge, skills, confidence in self-care. - higher the score the better (scored 0-52) -predicts health care outcomes, medication adherence and ER visits. health risk assessment predictive screening tool: patient's self assessment of their health and how likely they will seek care. - predicts future health costs - predicts likely-hood of progression of their illness to a worse condition. - examples: PHQ-9, etc. rose Q health risk assessment for angina, MI, coronary heart disease. defined angina pectoris as, "a chest pain or discomfort with these characteristics: (a) the site must include either the sternum (any level) or the left arm and left anterior chest (defined as the anterior chest wall between the levels of clavicle and lower end of sternum), (b) it must be provoked by either hurrying or walking uphill (or by walking on the level, for those who never attempt more), (c) when it occurs on walking it must make the subject either stop or slacken pace, unless nitroglycerin is taken, (d) it must disappear on a majority of occasions in 10 min or less from the time when the subject stands still." Possible myocardial infarction1 was defined as, "one or more attacks of severe pain across the front of the chest lasting for 30 min or longer." seattle angina questionnaire 19-item self-administered health risk assessment for angina and functional artery disease measuring five dimensions of coronary artery disease: 1 physical limitation, 2 anginal stability, 3 anginal frequency, 4 treatment satisfaction and 5 disease perception. -score of 0 to 100, where higher scores indicate better function (eg, less physical limitation, less angina, and better quality of life). arthritis impact measurement scales health risk assessment: Disease-specific measure of physical, social, and emotional well-being designed as a measure of outcome in arthritis. -scales: mobility, physical activity (walking, bending, lifting), dexterity, household activity (managing money and medications, housekeeping), social activities, activities of daily living, pain, depression, and anxiety. Score range: Range is 0-10 for each section. Total health score 0-60. -- Zero represents good health status, 10 and 60 represent poor health status. functional living index-cancer health risk assessment: Cancer-specific, functionally-oriented quality of life instrument. -22 items assessing 5 domains: Physical well-being and ability, emotional state, sociability, family situation, nausea - Higher score indicates better quality of life. BASIS-32 health risk assessment: 32-item Behavior and Symptom Identification Scale. behavioral health assessment tool. - measures the change in self-reported symptom and problem difficulty over the course of treatment. - assesses: Relation to Self and Others, Depression and Anxiety, Daily Living and Role Functioning, Impulsive and Addictive Behavior, Psychosis. - higher score poorer outcome mini mental state exam health risk assessment: 30-point questionnaire measures cognitive impairment to screen for dementia. - higher the score, less dementia - 18-23 is mild dementia - 0-17 is sever dementia hopkins symptom checklist-25 health risk assessment: self-reporting questionnaire symptom inventory which measures symptoms of anxiety and depression. -The scale for each question includes four categories of response ("Not at all," "A little," "Quite a bit," "Extremely," rated 1 to 4, respectively). Two scores are calculated: the total score is the average of all 25 items, while the depression score is the average of the 15 depression items mcgill pain questionnaire scale of rating pain. It is a self-report questionnaire that allows individuals to give their doctor a good description of the quality and intensity of pain that they are experiencing. Users first select a single word from each group that best reflects their pain. Users then review the list and select the three words from groups 1-10 that best describe their pain, two words from groups 11-15, a single word from group 16, and then one word from groups 17-20. After completing the questionnaire, users will have selected seven words that best describe their pain. A What part of Medicare covers skilled nursing facility? B What part of Medicare covers durable medical equipment? Goals 1. Patient focused 2. Measurable 3. Attainable 4. Relevant 5. Time oriented Piaget Developmental theory for cognitive ability to process/analyze information Assess, plan, implement/intervention, monitor/evaluation 4 stages of case management Sensorimotor: object performance and separation anxiety. Piaget's age 0-2, Preoperational: pretend, egocentric Piaget's stage age 2-6 Concrete operational: logical, math, conservation Piaget's stage 7-12 Formal operational: abstract, hypothetical Piaget's stage 12-adult Trust vs. mistrust Erickson 0-1 1/2 Autonomy vs. shame Erickson 1 1/5-3 Initiative vs. guilt Erickson 3-5 Industry vs. inferiority Erickson 5-12 Ego id vs. role confusion Erickson 12-18 Intimacy vs. isolation Erickson 18-40 Generative vs. stagnation Erickson 40-65 Integrity vs. despair Erickson 65+ Skinner Operational conditioning CMAG Case management adherence guidelines IM-CAG Inter med - complexity assessment grid CMAG assessment tool. Comprehensive approach to chronic therapy issues, ex: med adherence, COPD, DVR,DM,HTN, IM-CAG Electronic tool that provides risks and vulnerabilities of complex patients with actionable interventions. 4 domains: behavioral, social, health system. evidence based practice 1. Question 2. ID resources 3. Critically appraise resources 4. Apply evidence 5. Reevaluate application of evidence are 5 steps of what? Integrated CM Includes well being, disease management, case management, prevention, triage, utilization management Integrated case management 3 functions of ---- 1. Track patient self management 2. Tend/track population management 3. Reporting, monitoring quality Patient Poor attitude, memory loss, literacy, pride, fear, side effects, can't "see" results, decreased choices, finances are all ----- barriers