The Legal Nurse Consultant as Case Manager

2010 ◽  
pp. 147-172
Author(s):  
Valerie Parisi ◽  
Kathleen Kuntz ◽  
Second Edition ◽  
Doreen Casuto
Keyword(s):  
Case Manager ◽  
Nurse Consultant

Innovatives Leistungsmanagement führt zu mehr Professionalität, Effizienz und Kundennutzen

2017 ◽  
Vol 74 (1) ◽  
pp. 819-826
Author(s):  
Olaf Schäfer ◽  
Denise A. Camenisch
Keyword(s):  
Case Manager

Zusammenfassung. Innovatives Leistungsmanagement im Bereich der Kranken-, Krankentaggeld- und Unfallversicherung braucht evidenzbasierte, systemunterstützte Instrumente im Abwicklungsprozess. Helsana investiert in Methoden und Modelle zur evidenzbasierten Früherkennung von gesundheitlichen Beeinträchtigungen mit dem Risiko zur Chronifizierung. Parallel dazu werden fortlaufend Lösungsmassnahmen erarbeitet. Ein Beispiel für eine solche Lösung ist die Reintegration-Toolbox (RE Toolbox), die Helsana gemeinsam mit dem Schweizerischen Versicherungsverband SVV und IT-Partnern entwickelt hat. Die Lösung gleicht einzelne Krankheitsbilder oder Unfälle mit einer jeweiligen Kohorte ab. Dabei wird bestimmt, ob sich die einzelne Person zu ihrer Vergleichsgruppe im Normbereich der Arbeitsunfähigkeit verhält oder ob es Auffälligkeiten gibt und Massnahmen eingeleitet werden müssen. Die Gesundheitskosten und die Arbeitsunfähigkeit je Krankheits- oder Unfalldiagnose sind statistisch erhoben und hinterlegt. Sie dienen der Grobeinschätzung eines Falles bzw. zur Früherkennung von chronischen Entwicklungen. Eine weitere Lösung ist das Befragungsinstrument «StayWell». Für die Stabilisierung eines Menschen nach einem schweren Unfall, bei langandauernder Krankheit oder in der (Re-) Integrationsphase braucht es für den Erfolg die aktive Einbindung aller involvierten Parteien. In Zusammenarbeit mit Branchenpartnern, vor allem Arbeitgebern, hat Helsana das standardisierte, wissenschaftlich fundierte und systemunterstützte Befragungsinstrument «StayWell» entwickelt. Dieses erhebt die Potenziale und Handlungsdefizite der jeweiligen Person im persönlichen Kontext und in ihrer Arbeitssituation. Der Arbeitgeber oder Case Manager erhebt mittels eines Fragebogens die Ist-Situation. Dadurch werden individuell geeigneten Koordinations- und Stabilisierungsmassnahmen schneller erkannt und effizienter umgesetzt. Das Instrument ermöglicht eine schnellere Stabilisierung und damit einen höheren Gesundheitsnutzen für die Betroffenen und deren Arbeitgeber, sowie Kosteneinsparungen für alle Beteiligten.

Perspektiven von Medizinischen Fachangestellten zu teambasierter Behandlung von Patienten mit Panikstörung in der Hausarztpraxis – Eine qualitative Studie

2020 ◽  
Author(s):  
Wolfgang A. Blank ◽  
Karoline Lukaschek ◽  
Jörg Breitbart ◽  
Thomas S. Hiller ◽  
Christian Brettschneider ◽  
...  
Keyword(s):  
Case Manager ◽  
Qualitative Studie ◽  
Icd 10

Zusammenfassung Ziel der Studie Untersuchung der Perspektive von Medizinischen Fachangestellten (MFA) bezüglich der Mitwirkung in verhaltenstherapeutisch orientierten Interventionen in der Hausarztpraxis. Methode 15 MFA (w, 39,5 Jahre), Case-Manager in einem hausarztpraxis-unterstützten Übungsprogramm für Patienten mit Panik- und Angststörung (ICD-10: F41.0), wurden mittels semistrukturiertem Interviewleitfaden zur Rekrutierung von und Interaktion mit Patienten, Vermittlung der Übungen und der Implementierung in den Praxisalltag befragt. Die Interviews (n = 14) wurden dokumentiert, transkribiert und inhaltsanalytisch nach Mayring qualitativ analysiert. Ergebnisse MFA empfanden ihren Anteil an der Intervention im Rahmen der Rekrutierung und Bindung von Patienten ans Projekt durch Telefonkontakte als positiv. Schlussfolgerung Das Einbinden der MFA kann dazu beitragen, im Rahmen einer niedrigschwelligen Intervention Patienten mit psychischen Beschwerden in der hausärztlichen Versorgung gezielt zu unterstützen und den Hausarzt zu entlasten.

Strategie e azioni di community building per contrastare la povertà educativa: gli apprendimenti del Gruppo Cooperativo CGM

2020 ◽  
pp. 129-140
Author(s):  
Flaviano Zandonai ◽  
Simona Taraschi
Keyword(s):  
Focus Group ◽  
Community Building ◽  
Case Manager ◽  
Project Manager ◽  
Santa Cecilia

Il contributo proposto si basa sulla presentazione analitica e di taglio valutativo di alcune azioni progettuali di contrasto alla povertà educativa realizzate negli ultimi anni e che hanno consentito sia di rafforzare il sistema di offerta sia di promuovere comunità capaci di eserci-tare una funzione autenticamente educante. Nello specifico con "Family Hub Mondi per Crescere" (capofila consorzio Co&So, Firenze) viene presa in considerazione la figura del case manager. Il progetto "Icam" (Istituto Caute-la Attenuata Madri Detenute - Comune di Milano, Ministero della Giustizia, cooperativa so-ciale Genera) ha ricreato un contesto di "normalità" per lo sviluppo armonioso dei bambini e delle loro mamme nell'ambiente carcerario. La cura e il coinvolgimento del territorio e del-la comunità come valore per contrastare la povertà educativa sono azioni del progetto "Co-munità Santa Cecilia" (cooperativa Paolo Babini, Forlì). Infine "Passi Piccoli" (capofila cooperativa Koinè, Milano) ha utilizzato come strumento per prevenire la povertà educativa il coinvolgimento e l'inclusione di spazi e soggetti della città. L'analisi scongiunta sui quattro progetti è svolta attraverso interviste e focus group con i project manager locali in modo da approfondire anche il ruolo dei "sistemi esperti" che a livello locale orchestrano reti di servizi e azioni di community building.

scholarly journals FRI0032 REGIONAL AND WIDESPREAD PATTERNS OF NON-ARTICULAR PAIN ARE COMMON AT RA DIAGNOSIS AND CONTRIBUTE TO POOR OUTCOMES AT 12 MONTHS: A PROSPECTIVE STUDY OF PAIN PATTERNS IN CANADIANS WITH RA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 589-590
Author(s):  
V. Bykerk ◽  
O. Schieir ◽  
M. F. Valois ◽  
L. Bessette ◽  
G. Boire ◽  
...  
Keyword(s):  
Initial Therapy ◽  
Multinomial Regression ◽  
Research Support ◽  
Clinical Nurse ◽  
Early Ra ◽  
Nurse Consultant ◽  
Patient Reported ◽  
Poor Outcomes ◽  
A Prospective Study ◽  
Articular Pain

Background:Persistent pain can occur in early RA patients, despite improvement in synovitis and may be due to coexisting non-articular pain (NAP). Though NAP is often attributed to fibromyalgia and widespread NAP, regional NAP syndromes may be more common and under-recognized.Objectives:To describe patterns of NAP, predictors of persistent NAP and impact on outcomes in the first year following early RA diagnosis.Methods:Data were from participants enrolled in the Canadian Early Arthritis Cohort (CATCH) between2017-2019who completed 0,6,12-month evaluations with patient-reported outcomes [PROs] and clinical data available. We used the McGill Body Pain Diagram (BPD) to classify patients as experiencing no NAP, regional (RP:1-2 regions) or widespread NAP (WP:3-5 regions). Multinomial regression was used to identify baseline predictors of persistent RP and WP at 12-months. Multi-adjusted GEE with linear and logit links were used to estimate time-varying associations of NAP patterns with outcomes updated at each time point.Results:Study included 421 participants: 66% were female, with a mean(sd) age 56 (14); 72% were seropositive and 90% were treated with MTX ± csDMARDs as initial therapy. NAP at baseline was common (55%), with majority (62%) reporting regional NAP. NAP prevalence was 33% at 12 months (Figure). Female sex and baseline depressive symptoms were independent predictors of widespread NAP at 12 months while poorer function and lack of early MTX treatment independently predicted regional NAP, at 12 mos. Regional and widespread NAP were associated with lower likelihood of remission in adjusted models that accounted for changes in NAP and remission over time (Table).Figure.Point prevalence of regional and widespread NAP at baseline, 6 and 12 months.Table .Results of Multi-Adjusted GEE Logistic Regression showing Regional and Widespread NAP is associated with a reduced likelihood of achieving Stringent Remission TargetsConclusion:NAP is commonly reported in early RA pts seen in real world settings. Regional NAP was more common than WSP at all time-points, but both NAP patterns were associated lower odds of achieving remission targets by 12 months. These data support considering the role of NAP when assessing RA treatment efficacy during clinical visits and warrant different treatment approaches to reduce symptoms in RA patients receiving target-based care.Disclosure of Interests:Vivian Bykerk: None declared, Orit Schieir: None declared, Marie-France Valois: None declared, Louis Bessette Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi, UCB Pharma, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi, UCB Pharma, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Sanofi, Gilles Boire Grant/research support from: Merck Canada (Registry of biologices, Improvement of comorbidity surveillance)Amgen Canada (CATCH, clinical nurse)Abbvie (CATCH, clinical nurse)Pfizer (CATCH, Registry of biologics, Clinical nurse)Hoffman-LaRoche (CATCH)UCB Canada (CATCH, Clinical nurse)BMS (CATCH, Clinical nurse, Observational Study Protocol IM101664. SEROPOSITIVITY IN A LARGE CANADIAN OBSERVATIONAL COHORT)Janssen (CATCH)Celgene (Clinical nurse)Eli Lilly (Registry of biologics, Clinical nurse), Consultant of: Eli Lilly, Janssen, Novartis, Pfizer, Speakers bureau: Merck, BMS, Pfizer, Glen Hazlewood: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada, Edward Keystone Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, F. Hoffmann-La Roche Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Pfizer Pharmaceuticals, Sanofi-Aventis, Consultant of: AbbVie, Amgen, AstraZeneca Pharma, Biotest, Bristol-Myers Squibb Company, Celltrion,Crescendo Bioscience, F. Hoffmann-La Roche Inc, Genentech Inc, Gilead, Janssen Inc, LillyPharmaceuticals, Merck, Pfizer Pharmaceuticals, Sandoz, UCB., Speakers bureau: Amgen, AbbVie, Bristol-Myers Squibb Canada, F. Hoffmann-La Roche Inc., Janssen Inc., Merck, Pfizer Pharmaceuticals, Sanofi Genzyme, UCB, Diane Tin: None declared, Carter Thorne Consultant of: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Janet Pope Grant/research support from: AbbVie, Bristol-Myers Squibb, Eli Lilly & Company, Merck, Roche, Seattle Genetics, UCB, Consultant of: AbbVie, Actelion, Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eicos Sciences, Eli Lilly & Company, Emerald, Gilead Sciences, Inc., Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Speakers bureau: UCB, Susan J. Bartlett Consultant of: Pfizer, UCB, Lilly, Novartis, Merck, Janssen, Abbvie, Speakers bureau: Pfizer, UCB, Lilly, Novartis, Merck, Janssen, Abbvie

scholarly journals FRI0030 MORE THAN HALF OF NEWLY DIAGNOSED RA PATIENTS ARE NOT CONVINCED OF THE NECESSITY OF RA MEDICINES: ASSOCIATIONS WITH RA CHARACTERISTICS, SYMPTOMS, AND FUNCTION IN THE CANADIAN EARLY ARTHRITIS COHORT (CATCH)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 588.1-588
Author(s):  
V. Ta ◽  
O. Schieir ◽  
M. F. Valois ◽  
G. Hazlewood ◽  
C. Hitchon ◽  
...  
Keyword(s):  
Early Arthritis ◽  
Symptom Duration ◽  
Healthy Weight ◽  
Newly Diagnosed ◽  
Research Support ◽  
Chi Square ◽  
Clinical Nurse ◽  
Nurse Consultant ◽  
Symptom Level ◽  
And Function

Background:Although DMARDs are essential for early aggressive control of RA to reduce symptoms and disability, medication adherence is variable. Beliefs about the necessity of medications and safety concerns predict adherence and are modifiable.Objectives:To examine associations among RA medication necessity beliefs and concerns, sociodemographics, RA characteristics, symptom level and function in newly diagnosed RA patients.Methods:Baseline data were analyzed from participants in the Canadian Early Arthritis Cohort (CATCH) who enrolled between 2017-2020 and completed the Beliefs about Medicine Questionnaire (BMQ) and PROMIS-29. All met ACR1987 or 2010 ACR/EULAR criteria and had active RA at enrollment. BMQ Necessity (N) and Concerns (C) scores were classified ashigh(≥20) orlow(<20) and categorized into: Accepting (↑N ↓C); Ambivalent (↑N↑C); Sceptical (↓N↑C); and 4) Indifferent (↓N↓C). Groups were compared using ANOVA and chi-square tests.Results:The 362 patients were mostly white (83%) women (66%) with a mean (SD) age of 56 (15), symptom duration of 6 (3) months, and 32% were obese (BMI≥30). More than half (56%) were DMARD-naive or minimally exposed. Mean N and C scores were similar between men and women; 54% were classified asIndifferent, 31%Accepting, 9%Ambivalent,and 6%Sceptical.As compared to those classified asAccepting, moreIndifferent participantssmoked, had a healthy weight, lower TJCs, and trend for lower CDAI (Table). Groups were similar by sociodemographics, symptom duration, and DMARD/steroid use, except fewerIndifferentpatients received MTX.Indifferentpatients had statistically and meaningfully lower patient global, depression, anxiety, fatigue and pain interference, and higher function and participation scores (Table).Conclusion:Many new RA patients had low medication necessity beliefs and concerns, and only 31% had high necessity beliefs and low concerns around diagnosis. Lifestyle and lower CDAI, TJCs, symptoms and functional impacts were associated with RA medication indifference. Identifying medication indifference can prompt discussions about medication beliefs/concerns to facilitate shared decision-making and adherence.Disclosure of Interests:Viviane Ta: None declared, Orit Schieir: None declared, Marie-France Valois: None declared, Glen Hazlewood: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada, Louis Bessette Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi, UCB Pharma, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Roche, Sanofi, UCB Pharma, Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Sanofi, Diane Tin: None declared, Carter Thorne Consultant of: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Janet Pope Grant/research support from: AbbVie, Bristol-Myers Squibb, Eli Lilly & Company, Merck, Roche, Seattle Genetics, UCB, Consultant of: AbbVie, Actelion, Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eicos Sciences, Eli Lilly & Company, Emerald, Gilead Sciences, Inc., Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Speakers bureau: UCB, Gilles Boire Grant/research support from: Merck Canada (Registry of biologices, Improvement of comorbidity surveillance)Amgen Canada (CATCH, clinical nurse)Abbvie (CATCH, clinical nurse)Pfizer (CATCH, Registry of biologics, Clinical nurse)Hoffman-LaRoche (CATCH)UCB Canada (CATCH, Clinical nurse)BMS (CATCH, Clinical nurse, Observational Study Protocol IM101664. SEROPOSITIVITY IN A LARGE CANADIAN OBSERVATIONAL COHORT)Janssen (CATCH)Celgene (Clinical nurse)Eli Lilly (Registry of biologics, Clinical nurse), Consultant of: Eli Lilly, Janssen, Novartis, Pfizer, Speakers bureau: Merck, BMS, Pfizer, Edward Keystone Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, F. Hoffmann-La Roche Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Pfizer Pharmaceuticals, Sanofi-Aventis, Consultant of: AbbVie, Amgen, AstraZeneca Pharma, Biotest, Bristol-Myers Squibb Company, Celltrion, Crescendo Bioscience, F. Hoffmann-La Roche Inc, Genentech Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Merck, Pfizer Pharmaceuticals, Sandoz, UCB., Speakers bureau: Amgen, AbbVie, Bristol-Myers Squibb Canada, F. Hoffmann-La Roche Inc., Janssen Inc., Merck, Pfizer Pharmaceuticals, Sanofi Genzyme, UCB, Vivian Bykerk: None declared, Susan J. Bartlett Consultant of: Pfizer, UCB, Lilly, Novartis, Merck, Janssen, Abbvie, Speakers bureau: Pfizer, UCB, Lilly, Novartis, Merck, Janssen, Abbvie

scholarly journals OP0076 HOW TO SELF-EXAMINE FOR TENDER AND SWOLLEN JOINTS: CO-DEVELOPMENT OF A TRAINING VIDEO FOR PEOPLE WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 41.1-41
Author(s):  
C. Sharp ◽  
K. Staniland ◽  
T. Cornell ◽  
W. Dixon
Keyword(s):  
Rheumatoid Arthritis ◽  
Decision Making ◽  
Disease Activity ◽  
Remote Monitoring ◽  
British Society ◽  
Patient Report Outcome Measure ◽  
Nurse Consultant ◽  
Patient Reported ◽  
Self Examination ◽  
Remote Consultations

Background:COVID-19 has catalysed the transformation of healthcare services, with outpatient services increasingly dependent upon remote models of care. Healthcare professionals now have to make clinical assessments based on remote patient examinations. The number of tender and swollen joints a patient has drives decision-making in RA, making it particularly important that people with RA and HCPs have a shared understanding of these examinations.Even before remote consultations became widespread, long gaps between clinic visits create challenges in enabling HCPs to form an accurate picture of disease activity over time. The REMORA (REmote MOnitoring of Rheumatoid Arthritis) app aims to address this issue by asking people with RA to track disease activity, including counting the number of tender or swollen joints, weekly(1). Data are integrated into the electronic patient record for clinicians to access with patients during clinical consultations. As part of the supporting materials for the REMORA app, we planned to develop a video to train people with RA how to examine their own joints. This video may now help meet the need created by the recent expansion in remote consultations.Objectives:To describe the co-production, implementation and evaluation of a video to train patients how to examine their own joints.Methods:The need for the video to fill a current gap in patient education was identified by the REMORA patient and public involvement and engagement (PPIE) group. A core working group comprising the PPIE lead, a nurse consultant, rheumatology clinicians, project and communications managers was formed. A storyboard was drafted and feedback gained from the PPIE group and wider REMORA team. Images were sourced from licenced suppliers, or co-developed with the PPIE group where necessary. No ethical approval was required as the PPIE group lead was acting as an equal member of the research term. Written informed consent was gained from video participants. Filming took place between two national lockdowns during the COVID-19 pandemic, providing a challenge to ensure social distancing and requiring the use of masks.Results:A 15 minute video to train people with RA to self-examine for tender and swollen joints was developed. An introduction outlining the rationale behind self-examination is followed by a nurse consultant coaching an RA patient in individual joint self-examination. Shoulders, elbows, wrists, metacarpophalangeal joints, proximal interphalangeal joints and knees are included, all of which are counted in disease activity scores.Early feedback from stakeholders has been overwhelmingly positive. The video will be publicly available on YouTube from February 2021. A survey of patients and HCPs aims to obtain more formal feedback on the video, with a view to a further iteration, if required. Leading national organisations in rheumatology will promote the video, as it supports national programmes including the British Society for Rheumatology national early inflammatory arthritis audit and ePROMS (electronic patient report outcome measure) platform, both of which include entry of patient reported tender and swollen joint counts.Conclusion:This video was co-designed by people with RA, aiming to support self-examination of tender and swollen joint counts. Hits on YouTube and survey responses will help assess its impact. Evaluation to assess whether the video affects patients’ ability to self-examine for tender and swollen joints before and after watching is planned. We hope the video will support remote consultations and help people with arthritis to better understand and self-manage their arthritis, and to have shared decision making conversations with their clinicians.References:[1]Austin L, Sharp CA, van der Veer SN, Machin M, Humphreys J, Mellor P, et al. Providing ‘the bigger picture’: benefits and feasibility of integrating remote monitoring from smartphones into the electronic health record: findings from the Remote Monitoring of Rheumatoid Arthritis (REMORA) study. Rheumatology. 2020;59(2):367-78.Disclosure of Interests:Charlotte Sharp: None declared, Karen Staniland: None declared, Trish Cornell Shareholder of: shares in Abbvie, Employee of: Abbvie, working as a Rheumatology Nurse Consultant, Will Dixon Consultant of: Google and Abbvie, unrelated to this work.

Case Management in Occupational Rehabilitation: Would the Real Case Manager Please Stand Up?

1995 ◽  
Vol 1 (2) ◽  
pp. 104-117 ◽  
Author(s):  
Dianna T. Kenny
Keyword(s):  
Case Management ◽  
Case Manager ◽  
Occupational Rehabilitation ◽  
Case Managers ◽  
Injured Workers ◽  
Policy And Practice ◽  
Post Injury ◽  
Proper Role ◽  
Key Stakeholders ◽  
Successful Case

Key stakeholders (injured workers, rehabilitation co-ordinators, rehabilitation providers, treating doctors and insurers) in the occupational rehabilitation process were interviewed to gain their perspective concerning the degree to which case management was viewed as the organising principle of post-injury management and to whom this role was most frequently assigned. Findings indicated that there were differences in stakeholder perceptions about who should fill this role for the injured worker, with the majority of each group claiming case management as their proper role. In contrast, 35% of the injured workers interviewed stated that they either did not have a case manager or that they case managed themselves. Although it was argued that rehabilitation co-ordinators are suitably placed to act as case managers, they were nominated least by injured workers. Three vignettes of successful case management were presented and recommendations for policy and practice were made.

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