Question
Select the nurse case management model used for patient care delivery that is accurately paired with one of its descriptors:
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A
The ProACT Model: Registered nurses perform the role of the primary nurse in addition to the related coding and billing functions
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B
The Collaborative Practice Model: The registered nurse performs the role of the primary nurse in addition to the role of the clinical case manager with administrative, supervisory and fiscal responsibilities
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C
The Case Manager Model: The management and coordination of care for clients throughout a facility who share the same DRG or medical diagnosis
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D
The Triad Model of Case Management: The joint collaboration of the social worker, the nursing case manager, and the utilization review team
Correct Response: D
The Triad Model of case management entails the joint collaboration of the social worker, the nursing case manager, and the utilization review team.
The Professionally Advanced Care Team, referred to as the ProACT Model, which was developed at the Robert Wood Johnson University Hospital, entails registered nurses serving in the role of both the primary nurse the clinical case manager with no billing and coding responsibilities; these highly specialized and technical billing and coding responsibilities are done by the business office, medical billers and medical coders.
The Case Manager Model entails the registered nurses’ role in terms of case management for a particular nursing care unit for a group of clients with the same medical diagnosis or DRG. In contrast to this Case Manager Model of Beth Israel Hospital, the Collaborative Practice Model of case management entails the role of some registered nurses in a particular healthcare facility to manage, coordinate, guide and direct the complex care of a population of clients throughout the entire healthcare facility who share a particular diagnosis or Diagnostic Related Group.
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