The Care Management department provides several major services to assure safe and efficient through-put of patients during their acute hospitalization and transition to the next level of care. Our goal is to balance individual clinical and psychosocial patient/family needs with the efficient and cost-effective utilization of resources while promoting quality outcomes.
RN case managers assess patients on admission for available family support, insurance resources, and potential discharge planning needs. They engage in daily multidisciplinary rounds Monday through Friday to develop and implement patient discharge plans with input from various other disciplines. The RN case manager is responsible for coordinating post-acute and discharge needs in a timely and cost-efficient manner. Using established criteria to determine appropriateness of continued hospital stay, RN case managers work with payors on obtaining needed authorizations for ongoing hospitalization and/or identified post-acute needs.
The RN Case Manager collaborates with the patient and family, members of the multidisciplinary team, community resources and agencies, and payors to ensure the patient’s progress and level of care is appropriately determined. Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management.
RN case managers also frequently lead multidisciplinary and family care conferences involving complex care situations. They contribute to meeting OHSU’s strategic plan of safe length of stay reduction and reduction in readmission rates.
Case Management is represented on every adult and pediatric unit and in the Emergency department. Each Case Manager has an office with a workstation near the unit they are assigned to. Communication factors: Case Managers are available by pagers, telephone/voicemail, Microsoft Teams, Epic Secure Chat, and e-mail.
Case Management is represented on every adult and pediatric unit and the Emergency department.
Communication factors: Case Managers are available 7 days a week between the hours of 0700-2300. They are available by pager, telephone, e-mail, and approved messaging applications.
Admit/ED Nurse Case Manager: In addition to the above basic CM functions, also provides the following –
RN Case Managers are responsible to be aware of and comply with regulatory requirements of DNV, Medicaid, Medicare and Oregon Nurse Practice Act.
Department Specific Working Conditions:
Case Management is represented on every unit and the Emergency department.
The Care Management central resource office is located in 9A4.
Each Case Manager has an office with a work station near the unit they are assigned to.
Communication factors: Case Managers are available by pagers 7 days a week during the day. They are also available by telephone/voicemail and e-mail.
Department Specific Requirements (competencies, equipment, certifications, etc.):
Proficiency within the interdisciplinary team in leading daily discharge rounds, negotiating conflicts, coordinating patient goals between disciplines, communicating about and educating physicians on patient status decisions.
Ability to describe what utilization review criteria is and how it is utilized.
Proficiency with managing difficult and sensitive family and provider care conferences including: adjustment to new levels of function, end of life discussions, imbalance of available resources (social, spiritual, medical, financial).
Progressive leadership positions with in nursing unit – examples include: Charge nurse, UBNPC Chair/Member, Shared Governance councils.
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