Patients who have suffered TBI (traumatic brain injury) should be referred for case management. Assessment, planning and implementation, and evaluation must be taken into account in determining the case management package. Factors in assessment include, but are not limited to: type of injury, risk of complications, likelihood of permanent impairment, who in the family makes the decisions, whether the patient meets criteria for the level of care, and coping ability of patient. Factors to be taken into account in planning include, but are not limited to: correct allocation of health care resources, coordination of benefits with various health care plans, determining appropriate level of care, identification/obtaining of available services, plans for movement through various levels to least restrictive level of care, plans for respite if necessary, home modifications, plans for continuing medical, transportation and psychological needs of patient and family members, and life care planning.
Questions to be asked in the evaluation component include, but are not limited to: Is the patient still progressing towards her/his goals at the maximum level of functioning? Is the setting the least restrictive setting possible? Are health care services being used effectively and efficiently? Are all the services for which the patient is eligible being offered? How is the family unit coping with the new situation? Is there depression or substance abuse present? Are there medical complications and is the family managing the complex medical needs?
http://casemanagerexam.com
