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A clinical pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or visit (homecare).
It involves an integrated system that manages the delivery of comprehensive healthcare services for enrolled patients. [1] Case managers are employed in almost every aspect of health care and these employ different approaches in the control of clinical actions.
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
The integrated care literature distinguishes between different ways and degrees of working together and three central terms in this respect are autonomy, co-ordination, and integration. While autonomy refers to the one end of a continuum with least co-operation, integration (the combination of parts into a working whole by overlapping services ...
Care is coordinated and/or integrated: Care is coordinated and/or integrated between complex health care systems, for example, across specialists, hospitals, home health agencies, and nursing homes, and also includes the patient's loved ones and community-based services. This goal can be attained though the utilization of registries, health ...
They may work in a broad range of settings that span the continuum of healthcare including office based physician practices, nursing homes, home health agencies, mental health facilities, and public health agencies. Health information managers may specialize in registry management, data management, and data quality among other areas.
A nurse operating medical equipment in an ambulatory care setting. Ambulatory care services typically consist of a multidisciplinary team of health professionals that may include (but is not limited to) physicians, nurse practitioners, nurses, pharmacists, occupational therapists, physical therapists, speech therapists, and other allied health professionals.
The significance of the CCC is a nursing terminology that completes the missing link needed to address nursing contribution to healthcare quality. Nursing care may be the most critical factor in a patient's treatment and recovery. [31] The partnership of nursing and technology is vital for designing nursing practice environments. [32]