Module C: Effective Resource Management

CE Credits: 1.5

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Hospitals and other healthcare organizations are in an increasing struggle to balance two goals: provide quality care and control costs, while also sustaining the organization’s financial health—a process known as resource management. This module explores the different components of an effective resource management plan, primarily utilization management, the process of determining the most efficient and effective treatment for a patient. Then, it explores how that process is shaped by regulatory and accrediting agencies (such as the CMS and the Joint Commission), and streamlined through the use of innovative software products.

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Learning objectives: After completing this module the case manager will be able to:
» Discuss the philosophy and importance of utilization management
» Describe the review process in utilization management
» Recognize the impact of oversight activities on resource management
» Describe the streamlining of resource management with software products
» Review the impact of resource utilization on the value and quality of patient care delivery

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Advance your professional practice: As the healthcare system continues to change—and often, get more complicated—CMs can support both our patients and our healthcare organizations by mastering the best practices of resource management, and bridging the clinical and the financial sides of healthcare.

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Improve organizational performance: The contributions that CMs and other transdisciplinary team members make in achieving higher quality, more efficient care combine to make two positive results: optimizing each patient’s experience and fostering improvements in overall healthcare delivery.