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Critical Components Of A Successful Chronic Care Management Program

The health of your patients is critical to your success as a healthcare organization. It's important to focus on prevention, rather than simply treatment. Chronic care management can help you do that. But what is it? Simply put, chronic care management (CCM) is a program that helps individuals manage their chronic conditions such as diabetes or hypertension over time—and usually for the rest of their lives—through a combination of medication management, behavioral change, and self-care skills training.

In addition to its overall benefits for patient health outcomes, chronic care management can help reduce hospital readmissions and emergency department visits while improving the quality of life for those who suffer from these illnesses. Here are some considerations when developing your own CCM program:


These key components help your organization improve chronic care management (CCM) program outcomes and patient experience.


It also increases patient satisfaction scores and hospital revenue. In addition to these benefits, there are many other areas that CCM programs can significantly impact:

Patient safety - When patients have access to their medical history at all times it allows providers to make better-informed decisions about their healthcare needs which leads to better outcomes for everyone involved in the process (patients, families, and caregivers).

Flow of information - With an electronic medical record system in place you will have access 24/7 from anywhere with internet access; this makes it easier for providers at different locations within your organization as well as those outside its walls (e.g., hospitals nearby) who may need additional information about a particular case before treating them properly so they don't make mistakes due lack thereof knowledge regarding said case history."


The CCM program has a dedicated person or team to coordinate care for patients with complex chronic conditions and high health risks.


Coordinators work with staff throughout the facility to ensure that appropriate care is provided at all times. This person or team reviews patient records conducts risk assessments and develops action plans to address areas of concern. This person or team reviews patient records conducts risk assessments and develops action plans to address areas of concern. Coordinators also work with staff throughout the facility to ensure that appropriate care is provided at all times. They are also the primary contact for patients and their families and work to ensure that they receive care that meets their needs.


A dedicated coordinator ensures the CCM program is not only accessible but always available to patients who need it when they need it.


This can be a challenge in and of itself, as many healthcare providers are stretched thin with multiple responsibilities and projects at any given time. However, an effective coordinator will keep tabs on all aspects of the program--from patient education materials to scheduling appointments--and make sure everything is running smoothly so that patients don't encounter any barriers when trying to access care through their primary care doctors or other health professionals.


A designated CCM champion is an invaluable asset because they are able to influence change within the organization and bring people together toward a common goal. They also help educate others about how a CCM program can be an integral part of improving patient care outcomes and satisfaction scores among staff members, caregivers, and families alike.


A good way to think about your role as a chronic care management champion is that you are the glue that holds everything together in your organization's efforts toward improving chronic disease management outcomes for patients. You may not always be visible at every meeting or event related to your CCM program, but without someone who has this kind of presence there would likely be gaps in communication between departments or individuals working on different aspects of the project at different times during its development cycle--and those gaps could end up causing problems later on down the road when they're finally noticed by someone else with less experience than yourself!


The more people know about your CCM program, the more likely they are to participate in it.


This can be achieved by educating the entire organization on chronic care management. The most effective way to do this is through an interdisciplinary team approach that includes nurses, physicians and other staff members. In addition, you should consider involving community leaders such as school principals or local business owners as well as community members who may not be associated with your facility but could benefit from becoming involved in some capacity (e.g., patients' family members).

Once you've established a solid base of support within your organization and community, it's time for expansion! You'll want to reach out beyond those who already know what CCM is all about so they can share their experiences with others who might not yet understand how important it is--or why they should get involved themselves if they haven't already done so.


We hope this article has given you a better understanding of the importance of chronic care management and how it can help improve patient outcomes. We have a number of services we can provide you with, so contact us today if you want to learn more!





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