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| interqual training for nurses: Introduction to Quality and Safety Education for Nurses Carolyn Christie-McAuliffe, PhD, FNP, 2014-03-14 Print+CourseSmart |
| interqual training for nurses: Introduction to Quality and Safety Education for Nurses Patricia Kelly Vana, MSN, RN, Beth A. Vottero, PhD, RN, CNE, Carolyn A. Christie-McAuliffe, PhD, FNP, 2014-03-14 This is the first undergraduate textbook to provide a comprehensive overview of essential knowledge, skill, and attitudes about safety in nursing practice. It reflects the six areas of nursing competencies as developed by the Quality and Safety Education Program for Nurses (QSEN) initiative, which are currently required content in undergraduate nursing programs. Using an inter-professional focus, the book addresses the fundamental knowledge required of entry-level nurses in each of the six QSEN areas: quality improvement, patient safety, teamwork and collaboration, evidence-based practice, informatics, and patient-centered care. The book includes all of the content required for nursing programs to be accredited by AACN or NLN. Contributors include nurse educators, faculty, researchers, administrators, case managers, quality improvement practitioners, and entrepreneurs of nursing as well as physicians and librarians from throughout the U.S. Readers will be privy to the unique perspectives of different health care partners who provide real life examples from an inter-professional team perspective. These include pharmacists, lawyers, physicians, librarians, quality improvement nurses, radiology technologists, nurse practitioners, hospital board members, patients, and others. Each chapter includes objectives, opening scenarios, case studies, critical thinking exercises, key terms, NCLEX-style questions, photos, tables, figures, web resources, recommendations for additional reading, and PowerPoint slides. An important feature of the book is the listing of QSEN competencies and the associated knowledge, skills, and attitudes (KSA) in the Appendix. Key Features: Comprises the only undergraduate text to address the six areas of requisite nursing competencies as developed by the QSEN initiative Provides a strong foundation for safe, evidence-based care Presents an inter-professional approach that reflects health care today Supports teaching with PowerPoint slides, critical thinking exercises, case studies, and rationales for review questions Includes objectives, critical thinking exercises, case studies, real world interviews, tables, figures, visuals, and suggested readings in each chapter |
| interqual training for nurses: Current Catalog National Library of Medicine (U.S.), 1979 First multi-year cumulation covers six years: 1965-70. |
| interqual training for nurses: Nursing Case Management Elaine Cohen, Toni G. Cesta, 2004-08-26 This classic resource offers complete coverage of nursing case management - from theoretical background and historical perspective to practical applications and how the field is changing to meet the challenges of today's health care environment. It focuses on the implementation of various case management models used throughout the United States and abroad. Key topics include the impact of public policy on health care; understanding the effects of health care reimbursement and its application at the patient level; throughput and capacity management; the impact of the revenue cycle; compliance and regulatory issues; and principles needed to improve case manager-client interaction. This helpful resource is designed to help nurse case managers assess their organization's readiness for case management, prepare and implement a plan to achieve necessary improvements and evaluate the plan's success. Includes numerous proven case management models currently being used in institutions across the country Organized to take the nursing case manager on a journey from the historical development of nursing case management to the successful implementation of a case management program Offers detailed guidance for planning, implementing, and evaluating a case management program Outlines the planning process with information on key topics such as analysis of the organization, the role of the organization's members, selection criteria for new case managers, case management education, credentialing, and partnerships Features guidelines for implementing a case management program with information on ethical issues, technology, compliance, and regulatory issues Addresses the evaluation component of developing and implementing a case management program by presenting information on outcomes, research, documentation, continuous quality improvement, measuring cost effectiveness, care continuum, and evidence-based practice Presents acute care and community based models of case management Highlights the evolution of collaborative models of case management, addressing key elements of joint decision-making, shared accountability, and interdisciplinary systems of care Addresses health care delivery through case management and public policy by presenting current legislative issues and their affect on both health care reimbursement and the application of care at the patient level Presents the insights, experiences, and advice of nursing administrators who have researched and successfully implemented nursing case management programs in various facilities |
| interqual training for nurses: Health Care Financial Management for Nurse Managers Janne Dunham-Taylor, Joseph Z. Pinczuk, 2006 Health Care Financial Management for Nurse Managers: Merging the Heart with the Dollar prepares nurse managers for successful interfacing between financial departments and nursing administration. Using a systems approach to analyze the financial impact of health decisions so nurse managers can thoroughly understand financial concepts such as staffing, budgeting, identifying and analyzing variance, measuring productivity, costing, accounting, and forecasting, the text also presents examples, techniques, and financial accounting terminology and demonstrates how cost cutting can affect patient outcomes. |
| interqual training for nurses: Nursing Case Management Suzanne K. Powell, 1996 |
| interqual training for nurses: Health Care Finance Steven R. Eastaugh, 1992-06-30 This book is a thorough, balanced, and insightful study of what is happening and what should be happening in health care financing. Americans want unlimited access to the best care at affordable prices. Fiscal pressures in American health care point in all different directions, like a pile of jackstraws. This important book analyzes how new payment incentives stimulate planned competition or reregulation; and the far-reaching impact these changes have on hospitals, physicians, long-term care facilities, HMOs, public health clinics, and multihospital systems. Tools for survival include better financial planning, productivity improvement, better scheduling systems, and total quality management. Steven R. Eastaugh begins his book with a general overview of cost management, accounting, product-line selection, and new payment incentives. Part II provides an in-depth survey of fiscal trends in long-term care, managed care, HMOs, and PPOs. Part III analyzes five basic strategies that a provider may consider; with special focus on market analysis, diversification, and pricing. The next part reviews physician payment options, the new Medicare 1992 payment systems for hospitals and physicians, and cost analysis of hospital patient care, research, and education. Part V considers productivity enhancement methods, incentives to assist productivity programs, and the Deming method of total quality management. Part VI focuses on investment, financing, and capital structure decisions in health care institutions and also in large multifacility systems. The last part summarizes major strategies for success in the 1990s, future policy alternatives, and suggests a number of alternative roads to universal entitlement and national health care reform. As Eastaugh suggests in this book, Our health system faces . . . immense opportunity and danger in a reformation on four fronts: access, efficiency, effectiveness, and quality of life. The challenge for providers and managers during this period of unparalleled opportunity is to win a clear victory on all four fronts, and not erode either access or quality in the name of efficiency. The range of coverage in Health Care Finance is extremely wide and detailed--making it essential and useful reading for health care professionals and students alike. |
| interqual training for nurses: Pennsylvania Public Employee Reporter , 1992 |
| interqual training for nurses: Case Management Suzanne K. Powell, 2000 The Second Edition of this comprehensive how to text has been completely revised and updated. This text outlines the basics of case management and illustrates some of the pitfalls encountered in the field of case management. The book provides information on the new Case Management Standards, supplies standard definitions and guidelines of case management for the practicing case manager, and presents information on caring for clients in a wide variety of health care settings. New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies. |
| interqual training for nurses: Modern Healthcare , 1988 |
| interqual training for nurses: Encyclopedia of Health Care Management Michael J. Stahl, 2003-10-21 The most comprehensive one-volume reference work on health care management published in the last 10 years, this work brings together much useful information and will appeal to a broad audience. Health science libraries, college libraries, and large public libraries will want to invest in this title. --BOOKLIST This volume should be considered by academic and public libraries with large healthcare management or business collections as the only current reference on this topic. --LIBRARY JOURNAL The Encyclopedia of Health Care Management would be useful for those involved in any aspect of health care, whether as a student, instructor, practitioner, researcher, or administrator. This book would be of great use in reference collections at public, university, hospital, and corporate libraries. --E-STREAMS Health care is one of today′s most discussed and debated topics. From issues such as accessibility to costs to quality, the debates range widely among doctors, patients, employers, and insurers. A popular topic in political campaigns and the media, health care and health care management is also a quiet and unremitting concern in the private and personal lives of individuals who worry about someday having to choose between food and prescription drugs. For this reason, in today′s health care industry, good business practices may be as important as the practice of medicine in assuring the continued health of the industry. The Encyclopedia of Health Care Management will prove invaluable to libraries serving students and professionals in health and business. It will also be an essential reference for physicians, providers and their employees, and students and professors in health and management for responsible and successful practice and administration in the health care industry. This encyclopedia is the most comprehensive reference work on the business of health care, with up-to-date information across a broad range of issues affecting every aspect of the industry and the people it serves, employs, and influences. Key Features The most comprehensive reference work on health care management Broad range of timely topics, spanning academic, corporate and governmental arenas Over 600 entries More than 160 expert contributors in the fields of medicine, public health, and business Tables on Health Care Acronyms Medical Degrees Medical Legislation Medical Organizations Medical Specialties About the Editor Michael J. Stahl, Ph.D. is Director of the Physician Executive MBA Program and Distinguished Professor of Management in the College of Business at the University of Tennessee, Knoxville. Dr. Stahl received his B.S. in Electrical Engineering from the State University of NY at Buffalo and his Ph.D. in Management from Rensselaer Polytechnic Institute. From 1982-1989, Stahl was Head of the Management Department at Clemson University He was Associate Dean in the College of Business at the University of Tennessee from 1989-1997. Dr. Stahl has published over 50 journal articles in a variety of areas including Strategic Management, TQ, and healthcare, as well as twelve books including Strategic Management, Perspectives in TQ, and The Physician′s Essential MBA. He teaches strategy and business planning in the Physician EMBA, Taiwan EMBA, and MBA Programs. Recommended Libraries Academic, Public, Special, Private/Corporate |
| interqual training for nurses: Medical Assistant Study Guide Ascencia, 2020-08-14 |
| interqual training for nurses: ILSA Journal of International & Comparative Law , 2001 |
| interqual training for nurses: Guidelines for Clinical Practice Institute of Medicine, Committee on Clinical Practice Guidelines, 1992-02-01 Guidelines for the clinical practice of medicine have been proposed as the solution to the whole range of current health care problems. This new book presents the first balanced and highly practical view of guidelinesâ€their strengths, their limitations, and how they can be used most effectively to benefit health care. The volume offers: Recommendations and a proposed framework for strengthening development and use of guidelines. Numerous examples of guidelines. A ready-to-use instrument for assessing the soundness of guidelines. Six case studies exploring issues involved when practitioners use guidelines on a daily basis. With a real-world outlook, the volume reviews efforts by agencies and organizations to disseminate guidelines and examines how well guidelines are functioningâ€exploring issues such as patient information, liability, costs, computerization, and the adaptation of national guidelines to local needs. |
| interqual training for nurses: Improving the Quality of Health Care for Mental and Substance-Use Conditions Institute of Medicine, Board on Health Care Services, Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders, 2006-03-29 Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€use conditions will benefit from this guide to achieving better care. |
| interqual training for nurses: Survival Strategies for Nurses in Managed Care Toni G. Cesta, 2002 This book helps nurse managers define their role in the managed care system, learn strategies in financial management and focus on preventative care, while working on re-engineering patient care delivery systems, utilization, and outcomes management. It addresses topics from defining managed care andexplaining how a company works, to addressing ethical and legal issues that arise in the managed care system. |
| interqual training for nurses: Epidemiology and the Delivery of Health Care Services Denise M. Oleske, 2012-12-06 In this introductory textbook to epidemiology, students will discover the knowledge and skills required for managing population-based health care under health reform. Fundamental epidemiological techniques are presented teaching students to assess the health status of populations served; determine appropriate interventions based upon knowledge of factors which affect health status; and evaluate the impact of health care systems, programs, technologies, and policies on the health status of populations. Each chapter includes case studies and discussion questions. |
| interqual training for nurses: Health Planning Reports Corporate Author Index United States. Bureau of Health Planning, 1981 Lists citations to the National Health Planning Information Center's collection of health planning literature, government reports, and studies from May 1975 to January 1980. |
| interqual training for nurses: International Who's who of Professionals , 2001 |
| interqual training for nurses: 2022 CDI Pocket Guide Pinson & Tang LLC, 2021-10-15 |
| interqual training for nurses: CCM Certification Made Easy Andrea Morris, 2016-07-20 We are extremely pleased to tell you that CCM Certification Made Easy has been updated to it's Second Edition, and includes all the new material recently added to the CCM Exam. Every subdomain is covered on the exam. CCM Certification Made Easy is clearly the most complete CCM Exam prep book you can buy.Up to date - every area has been revisited for this updated edition to keep pace with the substantial changes in healthcare and the CCM Exam.Includes a condensed versions of the CCMC's Glossary of Terms that are an essential resource to pass the CCM Exam.Includes a website link to download a free companion workbook and study strategies that countless case managers have used to pass the CCM Exam at no extra charge. |
| interqual training for nurses: Denial Management Pam Waymack, 2005 |
| interqual training for nurses: Compendium of HHS Evaluations and Relevant Other Studies HHS Evaluation Documentation Center (U.S.), 1985 Evaluations of programs conducted under HHS. Arranged according to agency sponsor, project title, report title, performer, abstract, descriptors, status start/end dates, and other identifying information. Subject, sponsor, program name indexes. |
| interqual training for nurses: USAF Medical Service Digest , 1993 |
| interqual training for nurses: The Hospital Guide to Contemporary Utilization Review Stefani Daniels, Ronald L Hirsch, MD, Facp, Chcqm, Ronald L. Hirsch, 2015-04-16 The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives |
| interqual training for nurses: Medicare Institute of Medicine, Committee to Design a Strategy for Quality Review and Assurance in Medicare, 1990-02-01 Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of careâ€how it is defined, measured, and improvedâ€and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students. |
| interqual training for nurses: Burn Rehabilitation, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book Karen J. Kowalske, 2023-10-10 In this issue of Physical Medicine and Rehabilitation Clinics, guest editor Dr. Karen Kowalske brings her considerable expertise to the topic of Burn Rehabilitation. Top experts in PM&R discuss key topics such as inpatient rehabilitation; hand burns; exercise; pediatrics and geriatrics; psychological issues; outcomes; and more. - Contains 13 relevant, practice-oriented topics including acute care of burns; early mobilization; hypertrophic scar; neuromuscular complications; reconstruction; and more. - Provides in-depth clinical reviews on burn rehabilitation, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews. |
| interqual training for nurses: Medical Quality Management Angelo P. Giardino, Lee Ann Riesenberg, Prathibha Varkey, 2020-08-31 This comprehensive medical textbook is a compendium of the latest information on healthcare quality. The text provides knowledge about the theory and practical applications for each of the core areas that comprise the field of medical quality management as well as insight and essential briefings on the impact of new healthcare technologies and innovations on medical quality and improvement. The third edition provides significant new content related to medical quality management and quality improvement, a user-friendly format, case studies, and updated learning objectives. This textbook also serves as source material for the American Board of Medical Quality in the development of its core curriculum and certification examinations. Each chapter is designed for a review of the essential background, precepts, and exemplary practices within the topical area: Basics of Quality Improvement Data Analytics for the Improvement of Healthcare Quality Utilization Management, Case Management, and Care Coordination Economics and Finance in Medical Quality Management External Quality Improvement — Accreditation, Certification, and Education The Interface Between Quality Improvement and Law Ethics and Quality Improvement With the new edition of Medical Quality Management: Theory and Practice, the American College of Medical Quality presents the experience and expertise of its contributors to provide the background necessary for healthcare professionals to assume the responsibilities of medical quality management in healthcare institutions, provide physicians in all medical specialties with a core body of knowledge related to medical quality management, and serve as a necessary guide for healthcare administrators and executives, academics, directors, medical and nursing students and residents, and physicians and other health practitioners. |
| interqual training for nurses: The Hospital Medical Staff , 1982 |
| interqual training for nurses: CCM Certification Study Guide 2020-2021 Trivium Case Manager Exam Prep Team, 2019-09-23 You're probably thinking this is just another typical study guide. Because we know your time is limited, we've created a product that isn't like most study guides. With Trivium Test Prep's unofficial CCM Certification Study Guide 2020-2021: Exam Prep Book and Practice Test Questions for the Certified Case Management Exam you'll benefit from a quick but total review of everything tested on the exam with real examples, graphics, and information. Imagine having your study materials on your phone or tablet! Trivium Test Prep's NEW CCM Certification Study Guide 2020-2021 comes with FREE online resources, including: practice questions, online flashcards, study cheat sheets, and 35 tried and tested test tips. These easy to use materials give you that extra edge you need to pass the first time. CCMC was not involved in the creation or production of this product, is not in any way affiliated with Trivium Test Prep, and does not sponsor or endorse this product. Trivium Test Prep's CCM Certification Study Guide 2020-2021 offers: A full review of what you need to know for the Next Generation ACCUPLACER exam Practice questions for you to practice and improve Test tips to help you score higher Trivium Test Prep's CCM Certification Study Guide 2020-2021 covers: Introduction Case Management Concepts Principles of Practice Psychosocial Aspects Healthcare Management and Delivery Healthcare Reimbursement Rehabilitation ...and includes 1 FULL practice test! |
| interqual training for nurses: Emergency Department Case Management, Second Edition Kathleen Walsh, Karen Zander, 2014-11-14 From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition will ensure that ED case management staff have a solid and sustainable foundation in place. After exploring models and reviewing emergency department infrastructure, this compendium will help readers outline key partnerships, present multiple options for case finding, tackle observation status accurately, address quality and evaluation issues, and identify ways ED RN case managers and social workers coordinate care for complex cases, such as pediatric, psychiatric, homeless, and uninsured populations. In addition to many new tools, this book is also packed with more than 20 detailed spotlights and case studies discussing ED case management strategies, best practices, and experiences of ED professionals from across the country. The new edition includes: The presence of case management RNs and Social Workers in emergency departments (ED) has become a standard since the first edition of this text was published in 2007. Ever-expanding and changing regulations for EDs and hospitals have emerged, while best practices have evolved to address these challenges. This new edition discusses these changes and provides updated guidance on running a compliant, effective, and efficient case management team in the ED. It also provides insight on adapting the role of case management based on unique ED patient populations and helps ED case managers stay ahead of the curve by examining what lies ahead in their profession. |
| interqual training for nurses: The Managed Care Contracting Handbook Maria K. Todd, 2009-03-26 Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer |
| interqual training for nurses: California Department of Corrections Elaine M. Howle, 2009 This report concludes that overall, Corrections¿ payments for hospital care services have risen $59.4 million from FY1998-99 through 2002-03, and grew at an average rate of 21% per year, outpacing the nat. consumer price index average of 8% annual growth for hospital services during this same period. The reasons for this growth can be attributed to the combination of more expensive health care and to Corrections¿ increased use of contracted hospital facilities. Analysis indicates that increases in its inpatient hospital payments are driven primarily by more expensive services, whereas increases in its outpatient hospital payments are driven by increases in both the price of services and number of hospital visits. Charts and tables. |
| interqual training for nurses: Foundations of Case Management Deanna Cooper Gillingham, 2021-10-16 |
| interqual training for nurses: Understanding Pharmacy Reimbursement F. Randy Vogenberg, 2006 As a health system pharmacist dealing with health care reform initiatives and accountable care organizations, it is important to have a fundamental understanding of health care reimbursement that has a focus on pharmacy. Understanding Pharmacy Reimbursement is the essential resource that allows you to more effectively deal with the rapidly changing and constantly emerging reimbursement issues over the next few years. |
| interqual training for nurses: Section 1557 of the Affordable Care Act American Dental Association, 2017-05-24 Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state. |
| interqual training for nurses: Case Management in Healthcare Peggy Rossi, 1999 Case Management in Health Care is a comprehensive reference designed to educate nurses and other health care professionals on the processes involved in case management. This reference discusses interventions and collaboration efforts that are necessary to move the patient through the continuum of care. It explores the changes in case management and it explains the financial, legal, and service aspects of this field. It is appropriate for nursing students (undergraduate and graduate) as well as for practicing case managers. • Focuses on the most current topics that are based on the changes and trends in case management and health care. • Addresses health care policies, laws and regulations as they apply to a case manager's day-to-day responsibilities. • Presents the basics on health insurance and the alternate funding programs equipping case managers to become active advocates for their patients. • Explores the pitfalls and barriers frequently encountered when locating appropriate patient resources, and explains how to overcome them. • Discusses various levels of care and treatment settings outside the acute care setting (ex. skilled nursing facility and home health care). • Explains the increasing number of case management models that are being used in various clinical settings. • Compares the roles and responsibilities of a utilization manager and a case manager, emphasizing the need for their collective efforts in providing quality patient care. • Case Management and Technology, focuses on systems support, technology tools and resources, meaningful reporting, using the Internet, and video conferencing in relation to effectively serving patients. • Quality Management for Case Managers, covers guidelines for quality management, organization standards and practices, accountability, increasing customer satisfaction, and measuring utilization and costs. • Audits, identifies auditing entities and discusses development of successful competency programs to meet regulatory standards specific to case management. • The Importance of Credentialing, discusses the significance of credentialing as the start of the quality process of an organization. • Discusses new modalities for case management such as demand management, care management, drug state management, and disability management. • Addresses the complexity of the moral and ethical issues facing today's case managers. • Includes content on worker's compensation, on-site vs. telephonic case management, and tools to improve the case management practice. • Tips and training tools for care givers are updated to include agencies, literature, and various web sites dedicated to care giving. • Expanded content on legal and legislative issues such as the Balanced Budget Act (BBA), Emergency Medical Treatment and Active Labor Act (EMTALA), and Health Insurance Portability and Accountability Act (HIPPA). • Provides current coverage of funding and insurance programs such as Medicare, Medicaid, Children's health coverage, Veteran's benefits, and TRICARE. • Content in Complex Care and Post Acute Care units have been expanded to include the latest advances in emergency care, hospice, and managing geriatric, transplant, mentally ill patients. • Each chapter begins with Objectives that list key points and focus the reader on essential content to better prepare them for learning. • Suggested Websites and Resources listed at the end of chapter provide reader with opportunity for further study and research. • End of Chapter Exercises (1-5 questions) promote active learning and application of pertinent content. |
| interqual training for nurses: Principles and Practice of Hospital Medicine, Second Edition Sylvia C. McKean, John J. Ross, Daniel D. Dressler, Danielle Scheurer, 2016-10-22 The leading textbook of hospital medicine – completely updated to reflect today’s challenges A Doody’s Core Title for 2021! Since its publication in 2012, Principles and Practice of Hospital Medicine, Second Edition has become the field’s premier resource. Comprehensive, authoritative, and practical, this landmark text provides a solid grounding in clinical, organizational, and administrative areas central to the practice of hospital medicine. The Second Edition has been completely updated to reflect the evolving practice responsibilities of hospitalists. Examples include value-based medicine, expanded surgical content, bedside clinical reasoning, and a new segment devoted to rehabilitation and skilled nursing care. This edition also features a more accessible and streamlined full-color design enriched by more than 600 illustrations. Each clinical chapter opens with boxed Key Clinical Questions that are addressed in the text and summarized in hundreds of tables. Case studies demonstrate how to apply this information specifically to the management of hospitalized patients. Representing the expertise of more than two hundred renowned contributors, Principles and Practice of Hospital Medicine, Second Edition is logically divided into six sections: The Specialty of Hospital Medicine and Systems of Care Medical Consultation Rehabilitation and Skilled Nursing Care The Approach to the Patient at the Bedside Diagnostic Testing and Procedures Clinical Conditions in the Inpatient Setting Principles and Practice of Hospital Medicine, Second Edition is essential reading for clinicians who strive to optimize inpatient care and sharpen their leadership skills. |
| interqual training for nurses: American Psychiatric Association Practice Guidelines American Psychiatric Association, 1996 The aim of the American Psychiatric Association Practice Guideline series is to improve patient care. Guidelines provide a comprehensive synthesis of all available information relevant to the clinical topic. Practice guidelines can be vehicles for educating psychiatrists, other medical and mental health professionals, and the general public about appropriate and inappropriate treatments. The series also will identify those areas in which critical information is lacking and in which research could be expected to improve clinical decisions. The Practice Guidelines are also designed to help those charged with overseeing the utilization and reimbursement of psychiatric services to develop more scientifically based and clinically sensitive criteria. |
| interqual training for nurses: Compendium of HHS Evaluations and Relevant Other Studies HHS Policy Information Center (U.S.), 1985 |
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Using an inter-professional focus, the book addresses the fundamental knowledge required of entry-level nurses in each of the six QSEN areas: quality improvement, patient safety, teamwork and collaboration, evidence-based practice, informatics, and patient-centered care.
InterQual Provider Training - Masspartnership
What is InterQual? Effective Sept. 21, 2019, Beacon will begin using Change Healthcare’s InterQual ® medical necessity criteria. Using nationally recognized criteria is consistent with mental health parity requirements. Beacon is committed to strengthening and enhancing clinical quality by leveraging this best-in-class, evidence-based criteria.
Interqual Training For Nurses Full PDF - companyid.com
Professional Learning for Nurses argues that opportunities for interprofessional experiences teaching and learning should be consciously and deliberately built into educational programmes available to practitioners as they move along numerous
MEDICAL AUTHORIZATION USING INTERQUAL - Oklahoma.gov
22 May 2001 · INTERQUAL® REVIEW •Follow the rules in each highlighted box and answer the medical scenario questions. •Click Additional Criteria Completed.
Interqual Training For Nurses (Download Only) - companyid.com
Professional Learning for Nurses argues that opportunities for interprofessional experiences teaching and learning should be consciously and deliberately built into educational programmes available to practitioners as they move along numerous
InterQual Criteria - Change Healthcare
The InterQual Criteria portfolio offers comprehensive clinical decision support designed to strengthen patient outcomes and reinforce appropriate utilization by providing access to evidence-based clinical criteria.
Interqual Training Courses
Program for Nurses QSEN initiative which are currently required content in undergraduate nursing programs Using an inter professional focus the book addresses the fundamental knowledge required of entry level nurses in each of the six QSEN
Interqual And Milliman Training Full PDF - netsec.csuci.edu
training manual for nurses transitioning into case management, an easy-to-read reference guide for new case managers, and a source of inspiration, tools, and resources for seasoned professionals. With a flexible format, this book and CD-ROM offer practical information and customizable tools to
Interqual Training For Individuals (2024) - netsec.csuci.edu
New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies. interqual training for individuals: Improving the Quality of Health Care for Mental and Substance-Use Conditions Institute of Medicine, Board on Health C...
Interqual Training For Nurses - offsite.creighton.edu
7 Oct 2023 · Learning for Nurses argues that opportunities for interprofessional experiences teaching and learning should be consciously and deliberately built into educational programmes available to practitioners as they move along numerous pathways from education and
Mckesson Interqual Training (PDF) - goramblers.org
reflects the six areas of nursing competencies as developed by the Quality and Safety Education Program for Nurses QSEN initiative which are currently required content in undergraduate nursing programs Using an inter professional focus the book
InterQual Evidence-Based Criteria Portfolio - Business Wire
McKesson’s InterQual® Criteria portfolio helps support better patient outcomes through integrated, streamlined care management processes and evidence-based appropriateness of care decision...
MCKESSON INTERQUAL TRAINING (DOWNLOAD ONLY)
fundamental knowledge required of entry-level nurses in each of the six QSEN areas: quality improvement, patient safety, teamwork and collaboration, evidence-based practice, informatics, and patient-centered care.
What’s New: InterQual® 2015 & CareEnhance® Review
InterQual Learning Source McKesson’s InterQual Learning Source can help meet your staff development needs with rigorous and effective InterQual Criteria training options. Our blended learning programs include self-paced, Web-based training modules and a choice of virtual instructor-led or on-site instructor-led training.
Conducting a review
When you conduct a Level of Care review, you use InterQual® Criteria that is organized in decision-tree format. InterQual products that use this format include the following:
Finding and selecting a subset - prod.cue4.com
Depending on the product you select, you view criteria in either decision-tree format or Q&A format.
Clinical Development Process 2023
InterQual developers receive comprehensive, ongoing training in the concepts and methods of EBM and value-based clinical improvement to ensure that InterQual uses the best available timely, valid evidence to support improved clinical decision-making, outcomes, and value.
InterQual Delivery Options Intelligent, Evidence-Based
InterQual Transparency Solution Health plans can give providers access to the InterQual Criteria that are critical to their practices in an intuitive, reference-only format via their provider portals. Physicians can simply log into the portal and click the link for InterQual Criteria. The criteria subsets you use appear in an easy-
Interqual Training For Case Managers Copy - companyid.com
nurses transitioning into case management an easy to read reference guide for new case managers and a source of inspiration tools and resources for seasoned professionals With a flexible format this book and CD ROM offer practical
Standards for competence for registered nurses - The Nursing …
All nurses in all four fields of nursing must demonstrate competencies across the four areas; professional values, communication and interpersonal skills, nursing practice and decision making and leadership, management and team working. All areas (known formally as domains) are explained fully for clarity.
