Access Point Case Management and the 2 Midnight Rule
Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, educating case management professionals and assisting in the implementation of case management departmental changes.
The author of nine books and a frequently sought after speaker, lecturer, and consultant, Dr. Cesta is considered one of the primary thought leaders in the field of case management.Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management journal in which she shares insights and information on current issues and trends in case management.
Prior to her current work as a case management consultant, Dr. Cesta was Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. She was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program, and systems process improvement.
Dr. Cesta has also held positions as Corporate Vice President for Patient Flow Optimization and Director of Case Management. She also designed and implemented a Master’s of Nursing in Case Management Program and Post-Master’s Certificate Program in Case Management at Pace University in Pleasantville, New York. Dr. Cesta completed seven years as a Commissioner for the Commission for Case Manager Certification.
Access point case managers reside in emergency departments, admitting offices and transfer centers. Among their roles is to ensure that patients are placed in the right level of care upon admission. With the advent of the 2-midnight rule, this role has never been more important. In addition, they are vital in assisting in readmission reduction, discharge planning, and patient flow.
In this webinar, we will explore the unique roles of the ED and admitting office and transfer center case managers and social workers and how an initial assessment and clinical review can better ensure that the patient is placed in the correct setting right from the get-go. We will review the 2-midnight rule and the part that case management plays in managing it. This can better ensure a reduction in the use of Condition Code 44 or self-denials when patients get admitted to the incorrect level. ED staff also assists in reducing unnecessary admission and readmissions.
Learn how to prioritize which patients need case management at your routes of entry and how these positions can assist in-patient case managers as well. We will complete this webinar with a discussion of how to measure the impact of these roles on the department and the hospital.
The role of the case manager and social worker in the emergency department, as well as other routes of entry to the hospital, is critical to the success of any hospital-based case management department. The roles of the case management professionals are unique and specialized in these settings and as such must be clearly defined and understood. Whether you work in the ED or on an in-patient unit, you need to understand the value added by these roles and how they can be best carried out. Case managers and social workers in all settings must work collaboratively so if you want to be as up-to-date on these important roles.
- Introduction to access point case management
- Levels of care
- Role of the RN case manager
- Role of the social worker
- Definition of 2 Midnight Rule
- Role of case management in managing 2 Midnight Rule
- Prioritizing patients in the emergency department
- Discharge planning in the emergency department
- Patient through-put
- Evaluating emergency department case management outcomes
Course Level - Intermediate
Who Should Attend
- Directors of Case Management
- Directors of Social Work
- RN Case Managers
- Social Workers
- Directors of Quality Management
- Emergency Department leaders
- Vice Presidents of Nursing
- Directors of Finance
- Vice Presidents of Operations
Why Should Attend
- Review the concept of access point case management
- Discuss the role of the RN case manager in the ED
- Describe the role of the Social Worker in the ED
- Understand the 2 Midnight Rule
- Understand the relationship between the 2 Midnight Rule and case management
- Discuss how to prioritize access point patients
- Identify the role of through-put at access points
- Review the positive outcome achieved by access point case management