Memorial Health System’s Disease Management Programs offer case management by advanced practice nurses, registered nurses, and registered respiratory therapists with extensive training in their respective fields. Case management targets patients with complex disease processes, frequent hospitalizations and those at high risk for complications. We will provide answers to patient questions, closely monitor their condition and work with physicians to provide the highest quality of care.
The disease management programs provide a care delivery system that extends beyond geographic boundaries.
Currently, four outpatient disease management programs are available
The goals of the disease management programs are to:
- Decrease emergency department visits, hospitalizations and acuity if the need for admission arises.
- Maintain or enhance quality of care, patient satisfaction and health care provider satisfaction.
- Optimize health care resource utilization.
- Improve your quality of life.
The Disease Management programs are an adjunct to physician care. The physician continues to see you on a regular basis. After your initial program visit, a plan of care is discussed with the physician and supported by the case managers. Referring physicians are kept informed of each clinic visit with a comprehensive dictation, or by telephone contact if intervention is needed immediately.
Services Include:
- Assessment of physical, functional, social, psychological and financial status.
- Education with attention to disease process, medications, diet and self-monitoring to encourage early intervention for less costly and less dramatic episodes of illness.
- Development, implementation and monitoring of the plan of care with an interdisciplinary collaborative team approach.
- Introduction to community resources and patient assistance programs.
- Twenty-four hour telephone availability for you as well as frequent contact for follow-up.
You will be discharged from the program once your condition has stabilized and education is completed.
Contact Information:
For more information concerning these programs, please call 365-6987.
Memorial Health System | Memorial Hospital for Children | Foundation | PhysicianLink 