{{ (moduleVm.actions && moduleVm.changeStatus) ? moduleVm.status : '' }} Creating a New Model of Care by Integrating Case Management Nurses in a Children's Hospital

Activity Steps


The authors outline the process and results of the integration of a Nurse Case Manager (NCM) role in a pediatric hospital. The discussion included the barriers to implementing this new role and strategies to overcome them. The new program resulted in a proactive model of NCM/social worker/utilization management nurse. The outcomes included a decrease in the number of denials and an increase in the overturn of the denials received.

Learning Objectives

After completing this continuing education activity you will be able to:

  1. Identify barriers to effective pediatric care utilization and progression of care with a traditional dyadic utilization management nurse/social work care management model.
  2. Describe the training process and roles of a nurse case manager (NCM) in a children's health system.
  3. Summarize the benefits and limitations of using an NCM in a children's health system by applying information learned to a case scenario.

Learning Outcomes

By completing this activity and taking the posttest, participants will achieve a minimum score of 70%.
Price: $21.95


  • NAHQ 2.0 CEH

This continuing education (CE) activity is provided by Lippincott Professional Development and has been approved by the National Association for Healthcare Quality (NAHQ) for 2.0 CPHQ CE Hours. CPHQ CE Hours are based on a 60-minute hour. This CE is approved for meeting requirements for certification renewal.

Test Code: PCM0921B HQ
Published: Sep/Oct 2021
Expires: 9/1/2022
Required Passing Score: 7/10 (70%)
Authors: Maryanne Bourque, MS, BSN, RN, CRCR; Donna DeFilippis, BSN, RN, ACM-RN; Lisa Adkins, MSN, RN, CPNP, CRCR, CSAF