Course Provider
Learning Objectives
Care Planning Learning Objectives Describe the fundamental aspects of the care process. Define what assessment is, list the general components of a biopsychosocial assessment, and apply concepts related to assessment in care work. Define what a SWOT analysis is and apply it to care work. Identify client barriers to care and well-being and describe them in strengths-based language. Define what a care plan is and create a person-centered care plan. Explain the value of care planning in collaboration with interdisciplinary teams. Identify how to prioritize areas goals in care work for maximum impact and improvement. Define what a SMART goal is and apply this tool with clients. Explain common difficulties faced in end of life care and how to create appropriate goals during that time. Explain why flexibility is key to care planning.
Coordination of Medical Behavioral Treatment Learning Objectives Apply best practices for coordinating care for patients with co-morbid medical and/or behavioral conditions. Create an individual strategy for developing effective working relationships with medical providers and interdisciplinary team patients that will foster a know, like and trust relationship with the Care Manager. Identify three questions a Care Manager can ask a provider to validate the need and benefit from care management. Describe effective negotiation strategies that a Care Manager would use to obtain services for a patient that are not covered by the health plan. Define the special needs of individuals with behavioral health conditions and mental health disorders Identify and explore challenges in behavioral care management. Describe the value of an interdisciplinary approach to substance use and addiction treatment. Explain recent legislative changes in support of integrating medical and behavioral health treatment. Compare and contract an integrated approach versus a traditional approach to the coordination of behavioral health treatment. Discuss the concept of the Medical Care Home and how it will benefit patients with co-morbid medical and behavioral health conditions.
Coordination of Medical and Long Term Services and Support Learning Objectives Identify the differences between activities of daily living and instrumental activities of daily living. Describe the primary difference in what type of care is covered between Medicare and Medicaid. Define the differences between Inter Multi and Trans-disciplinary teams. Describe the various settings patients can transition from acute care to a community setting. Identify the 2 primary issues that typically impact a family members ability to care for a patient in the home environment. Describe what it means to age in place.
Confirmation and Reconciliation of Medicine Learning Objectives Define medication reconciliation as a formal patient safety practice. Outline strategies to minimize risks, utilize and communicate safe practices associated with the use of IV push medications for adults. Communicate the need for a collaborative interdisciplinary approach to medication safety. Describe what is known about potential harms associated with unintended medication changes at care transitions. Describe multiple interventions that address the hazard of medication errors. Examine the impact of automated tools for identifying a variety of medication error types and improving the medication reconciliation process. Discuss how cultural or religious beliefs can influence an individuals use of herbal, alternative or folk medicine remedies. Prepare and administer medications safely
Provision of Resources: Community Support and Advocacy Learning Objectives Identify the main difference between informal and formal community support. Define the primary differences between professional advocacy, grass roots or self- generated advocacy, and education advocacy Describe the primary areas that should be assessed to address patient resource needs Identify concrete resources for the primary areas of assessment List reasons for resistance to resources and strategies for overcoming resistance Describe the
Facilitating Patient Activation and Engagement Learning Objectives Define patient activation and engagement. Explain the importance of engaging in a merged philosophy of activation and engagement for promoting person-centered care Explain the role of patient activation and engagement on improving health outcomes, advancing client experience, improving quality and lowering costs Describe, select, and administer three patient activation and evaluation measurement tools Explain the role of the healthcare professional in promoting patient activation and engagement. Apply strategies for improving professional activation and engagement Detail the impact of health literacy and patient safety, learning styles, personal culture, and psychosocial experience on patient activation and engagement. Apply best practice strategies for assessing barriers, deterrents and set-backs for patient activation and engagement List best practice strategies for success-focused patient activation and engagement interventions Apply best practice strategies for improving and sustaining patient activation and engagement
Establishing Care Planning Goals and Discharge Criteria Learning Objectives Define person-centered care and describe its relevance in care management. Describe the fundamental aspects of the discharge process, including common discharge criteria. Explain how goals are created and utilized during discharge and apply that in their work. Identify when to transition session work toward discharge via awareness of discharge readiness. Describe how discharge processes can exist in interdisciplinary settings and explain how this may affect discharge readiness. Identify when clients need external support beyond the care relationship and describe how to coordinate that. Explain the relevance of patient advocacy and education as related to discharge and apply that knowledge for client empowerment. Identify care manager responsibilities post-discharge.