Mission and Vision
Support the Army mission, by ensuring high quality comprehensive healthcare to all beneficiaries with emphasis on prevention, cost effectiveness, & continuity, while fostering patient and family independence through education and support.
Medical Management… empowering independence; managing healthcare …planning for excellence.
Definition of Case Management
Case Management is a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet complex health needs through communication and available resources to promote quality, cost-effective outcomes. --Case Management Society of America, 2002
How Case Management Works
Assessment -The Case Manager evaluates the patient/family for services. Populations targeted include:
Plan - The Case Manager:
Assists the patient in establishing a successful treatment plan
Provides relevant condition/disease mgt education
Goal is to assist pt/family in becoming independent in self-care and self-determinate in reaching/maintaining optimal health
Implementation - Case Management:
Improves patient/family appropriate access to care and services
Advocates for patient/family and facility services and cost effectiveness
Monitors the ongoing treatment plan for effectiveness
Coordinate - The Case Manager:
Coordinates the plan of care
Communicates any changes to the plan of care to the team, patient, and family
If needed, coordinates medical supplies, equipment, or in-home services
Evaluate – The Case Manager will evaluate:
Who is a Candidate for Case Management?
Any of the following may indicate the need for Case Management evaluation:
Catastrophic illness or injury
Chronic or terminal illness
Multiple medical problems
Lack of family/social support
Non-compliance/resistance to treatment
Inability to follow treatment
Multiple Emergency Department visits
How to Enroll a Patient in Case Management
Contact your Clinic Case Manager directly.
Case Managers are available in the following clinics or areas:
Inpatient Case Management [Discharge Planning]
The government has established a Discharge Planning Program to help active duty and retired service members and their families to understand and access the healthcare system. At Womack Army Medical Center, the Discharge Planners are available on the second floor and on the in-patient wards.
The Role of the Inpatient Case Manager [Discharge Planner]
Inpatient Case Managers [Discharge Planners] are registered nurses who work with the medical staff and the patient to arrange extended care at home or in the community prior to discharge from the hospital. The discharge planner functions as a consultant for the discharge planning process within a health facility, providing education and support to hospital staff in the development and implementation of discharge plans. Discharge Planners coordinate all services that will allow patients to smoothly transition to the next level of care while keeping costs to the patient at a minimum.
**DISCHARGE PLANNERS DO NOT MAKE DIAGNOSIS OR TREATMENT DECISIONS.
The Discharge Planner will assess a patient’s needs; create a plan of care; educate the patient and their family, and help the individual to make the best decisions they can about their healthcare needs prior to hospital discharge.
Discharge planning may be helpful if you have:
Chronic or multiple health problems
A serious or terminal illness
More than one Provider for different specialties
Lack of family or community support
Difficulty following your Provider's plan of care
Discharge Planners may assist you in obtaining:
Home Health Services
Occupational, Physical or Speech Therapy Services
Medical equipment, i.e. wheelchairs, oxygen, etc
Use of the TRICARE/Health Net system
Inpatient Case Management/Discharge Planning Services
Your Provider, the leader of your health care team, works closely with your Discharge Planner to ensure that patients move onto another level of care whether it is:
Alternate acute care
Long term acute care
Nursing home care
Discharge Planners are available in the following inpatient areas:
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