A plan for community event-based surveillance to reduce Ebola transmission - Sierra Leone, 2014-2015.

Ebola virus disease (Ebola) was first detected in Sierra Leone in May 2014 and was likely introduced into the eastern part of the country from Guinea. The disease spread westward, eventually affecting Freetown, Sierra Leone's densely populated capital. By December 2014, Sierra Leone had more Ebola cases than Guinea and Liberia, the other two West African countries that have experienced widespread transmission. As the epidemic intensified through the summer and fall, an increasing number of infected persons were not being detected by the county's surveillance system until they had died. Instead of being found early in the disease course and quickly isolated, these persons remained in their communities throughout their illness, likely spreading the disease.

School Nurse-Led Care Coordination: Proceedings From the National Strategy to Action Roundtable.

This article describes the process for convening a national Roundtable that brought together multiple stakeholders to create a united vision and collaborative approach to care coordination for students with chronic health conditions and introduces the resulting published Translating Strategies into Actions to Improve Care Coordination for Students with Chronic Health Conditions white paper. Schools across the country are engaged to various degrees in addressing the health and academic success of students with chronic health conditions. Lack of a common definition of care coordination presents ongoing challenges to planning, implementing, and evaluating outcomes of care coordination for students with chronic health conditions. The Roundtable's overarching goal was to identify recommended actions for health and education leaders to implement a system to support care coordination at the school and district level. School nurses can use this description of the National Association of School Nurses' approach when convening community stakeholders to address common concerns related to student health and academic success. The Roundtable outcomes presented can be used by health and education leaders in schools and school districts to design, implement, and sustain system change to support care coordination as a strategy to manage chronic health conditions in school, recognizing the school nurse's central role.

On the case: effective care transitions.

In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery.

Implications for case management: ensuring access and delivery of quality health care to undocumented immigrant populations.

Immigrants are an integral part of the history and diversity of the United States. Now more than ever, this growing population is facing a major challenge related to the widening gap in overall healthcare access and health insurance coverage. This gap raises concerns related to access, economics, fear of detection, and cultural/language barriers to care, which extend beyond the individual person to affect the community at large. This is particularly true for those immigrants who are residing in this country illegally. Healthcare providers, in general and hospitals in particular, face many challenges in providing care to this group. As the immigrant population continues to grow, the case management community will face an ongoing challenge to expand and refine its knowledge base and incorporate key competencies into its practice patterns in order to ensure access to and delivery of healthcare to this largely underserved group. This article specifically addresses the undocumented population, and identifies opportunities to encourage and promote access to healthcare while providing effective care management interventions.

The case manager's role in optimizing acute rehabilitation services.

As patients move across the healthcare continuum at a faster pace, the role of the case manager within alternative care settings has become increasingly crucial in assuring that the care delivered demonstrates efficacy, efficiency, and high quality. This article explores the multidisciplinary role of the case manager in the acute rehabilitation setting and how effective case management interventions, such as coordination, collaboration, and advocacy among others, promote the delivery of comprehensive and cost-effective patient-centered care.

The effects of the Palliative Medicine Consultation on the DNR status of African Americans in a safety-net hospital.

OBJECTIVE: To examine the effectiveness of palliative medicine consultation on completion of advance directives/do-not-resuscitate (DNR) orders by racial/ethnic minorities. METHOD: A sample of 1999 seriously ill African American and Hispanic inpatients was obtained from the Palliative Medicine Consultation database (n = 2972). Associations between race/ethnicity and diagnosis and documentation of DNR status on admission and discharge were examined. RESULTS: Cancer was the primary diagnosis, 34.5%. Among patients with a consultation, 98% agreed to discuss advance directives; 65% of African Americans and 70% of Hispanics elected DNR status. Inpatient deaths were 46%; 74% of decedents agreed to DNR orders. Discharged patients referred to hospice were 29%. CONCLUSION: Palliative medicine consultations resulted in timely completion of DNR orders and were positively associated with DNR election and hospice enrollment.

ILI-related school dismissal monitoring system: an overview and assessment.

OBJECTIVE: This report provides an overview and assessment of the School Dismissal Monitoring System (SDMS) that was developed by the Centers for Disease Control and Prevention (CDC) and the US Department of Education (ED) to monitor influenza-like illness (ILI)-related school dismissals during the 2009-2010 school year in the United States. METHODS: SDMS was developed with considerable consultation with CDC's and ED's partners. Further, each state appointed a single school dismissal monitoring contact, even if that state also had its own school-dismissal monitoring system in place. The SDMS received data from three sources: (1) direct reports submitted through CDC's Web site, (2) state monitoring systems, and (3) media scans and online searches. All cases identified through any of the three data sources were verified. RESULTS: Between August 3, 2009, and December 18, 2009, a total of 812 dismissal events (ie, a single school dismissal or dismissal of all schools in a district) were reported in the United States. These dismissal events had an impact on 1947 schools, approximately 623 616 students, and 40 521 teachers. CONCLUSIONS: The SDMS yielded real-time, national summary data that were used widely throughout the US government for situational awareness to assess the impact of CDC guidance and community mitigation efforts and to inform the development of guidance, resources, and tools for schools.

Building collaborative partnerships in critical care: the RN case manager/social work dyad in critical care.

PURPOSE/OBJECTIVES: More than 5 million patients are admitted annually to intensive care units (ICUs) in the United States. As the life expectancy of the population continues to lengthen, we should expect to see a proportionate increase in the burden of acute and chronic illness as well as a rise in the demand for critical care services. The case management dyad team of nurse case manager and social worker enhances and supports the critical care team through the implementation of collaborative interventions that focus upon the (1) minimization of inpatient transitions, (2) reduction of cost by decreasing the length of stay, (3) promotion of patient and family satisfaction through efforts of advocacy, and (4) enhanced discharge planning. PRIMARY PRACTICE SETTING(S): Hospital ICUs. FINDINGS/CONCLUSIONS: In the critical care setting the professional partnership of the RN case manager/masters in social worker (RN/MSW) dyad is a core component in the linkage of the ICU support system and it enhances the functioning of the ICU multidisciplinary team. The efforts of the dyad team are congruent with the goals of patient care, with the desires of the family, and with the mission of the organization. Shared goals and a shared commitment to professional practice provide the essential building blocks of the dyad relationship. The dyad structure presents an opportunity for RN case managers and social workers to integrate their strengths and skills in a collaborative patient-centered effort. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The RN/MSW dyad structure as a model for case management practice promotes continuity of care and strengthens professional relationships. The case manager and the social worker have many shared responsibilities; therefore, a partnership that promotes continuous collaboration and communication is essential to the achievement of successful patient care outcomes. The professional partnership that evolves, as depicted by the RN/MSW dyad structure, enhances the organizations' mission to deliver quality patient-centered care.

Collaborations in leadership: the nurse case management and nursing administration connection.

PURPOSE/OBJECTIVES: With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. PRIMARY PRACTICE SETTINGS: All settings, particularly acute care hospitals and integrated delivery systems. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty.

Case managers optimize patient safety by facilitating effective care transitions.

In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery. Effective communication and collaboration between disciplines is key to the promotion of patient safety, and ultimately the avoidance of life-threatening medical errors. Across the healthcare continuum and within hospitals in particular, patients are routinely transferred from one service to another, from one level of care to another, or from one provider to another. As patients are stabilized and transitioned through the hospital system, there are multiple hand-offs of care or care transitions that can often expose the patient to fragmented service and increase the risk of communication breakdown. Ineffective hand-offs can result in a disruption of continuity between one level of care and the next. In a culture that places a strong emphasis on patient safety, case managers can facilitate opportunities that ease care transitions whereby a change in venue is no longer perceived as a disruption in the flow of care but rather is viewed as a coordinated changeover where cautious and comprehensive communication sets the tone for the continued delivery of safe and effective healthcare.