Community Based Chronic Disease Case Management Program Installation
Much emphasis has been placed on the development and implementation of Case Management methods designed to manage patients with chronic disease in an outpatient environment, minimizing hospitalizations and A&E visits. To accomplish these goals, the Community Based Case Management Program is required:
- Staffing Model Design and Implementation
- Community Case Management Staffing Model
- Community Case Management documentation tools
- Identification of patient clientele
- Installation of Clinical, Evidence Based Admission and Discharge Criteria for all levels of care (add link to The Oak Group here)
- Implementation of Integrated Pathways of Care
- Deployment of cyclic telephonic or internet based medical management monitoring systems