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ACM-RN study plan

ACM-RN · Give each week a clear focus.

8 weeks · About 6 hours per week

Week 1

Care Management and Coordination & Transitions of Care

  • Map the care management and coordination process end to end, from referral through closure, and label each step with the domain-1 competency it tests

  • Compare case management models (for example, chronic care model versus intensive case management) and write a one-paragraph contrast of each

  • Identify the standardized screening and assessment instruments commonly used in care management and state what each one measures

  • Explain how coordination differs from advocacy and from transition planning, with a clinical example of each

Your checkpoint

A one-page process map of the care management workflow with each step annotated by the domain competency it exercises

Week 2

Care Management and Coordination & Transitions of Care

  • Draft a care plan for a hypothetical complex patient that includes measurable goals, interventions, responsible parties, and review dates

  • Differentiate the case manager's roles of coordinator, navigator, and advocate in three short scenarios

  • Describe how interdisciplinary team meetings are structured and what the case manager contributes to them

  • List the warning signs of an unsafe or stalled transition and the action to take for each

Your checkpoint

A complete written care plan for one hypothetical patient, including at least five measurable goals and a transition risk assessment

Week 3

Chronic and Complex Care Management & Care Management and Coordination

  • Outline the case management approach to the major chronic conditions (diabetes, heart failure, COPD, and hypertension), including monitoring parameters and escalation triggers

  • Explain how multimorbidity changes prioritization and care planning

  • Describe the principles of motivational interviewing and write two sample exchanges that apply them

  • Identify the components of a self-management support plan and how to tailor it to health literacy level

Your checkpoint

A condition-by-condition reference sheet listing monitoring parameters and escalation triggers for four chronic conditions

Week 4

Chronic and Complex Care Management & Patient Advocacy and Education

  • Build a teaching plan for a newly diagnosed patient that accounts for readiness to learn, literacy, culture, and language

  • Distinguish patient education from patient counseling and from shared decision-making

  • Describe how to assess and document a patient's understanding using teach-back

  • Explain the case manager's duty when a patient declines a recommended intervention

Your checkpoint

A written patient teaching plan with a teach-back script and a documented response to a declined intervention

Week 5

Psychosocial and Behavioral Health & Patient Advocacy and Education

  • Screen a hypothetical patient for depression, anxiety, and substance use using validated tools, and interpret the scores

  • Describe how to respond to disclosed intimate partner violence, suicidal ideation, and suspected elder mistreatment, including reporting obligations

  • Explain how social determinants (housing, food, transportation, social isolation) shape the care plan

  • Distinguish the case manager's scope in behavioral health from the role of the licensed behavioral health clinician

Your checkpoint

A completed psychosocial assessment for a hypothetical patient with a written response plan for each identified risk

Week 6

Psychosocial and Behavioral Health & Program Evaluation, Quality, and Outcomes

  • Define the quality measures most relevant to case management, including readmission rate, adherence, and patient-reported outcomes

  • Explain how to select and interpret outcome, process, and balancing measures

  • Describe basic program evaluation designs and when each is appropriate

  • Identify how to use data to justify a change to a care management program

Your checkpoint

A one-page program evaluation outline with at least three measures, their data sources, and a proposed analysis

Week 7

Legal, Ethical, and Professional Practice & Program Evaluation, Quality, and Outcomes

  • Apply the core ethical principles (autonomy, beneficence, nonmaleficence, justice) to three case management dilemmas

  • Explain confidentiality, HIPAA, and the limits of disclosure in care coordination

  • Describe informed consent, advance directives, and surrogate decision-making

  • Identify the elements of negligence and how scope of practice and documentation protect the case manager

Your checkpoint

Three written ethical dilemma analyses, each applying the four principles and reaching a documented recommendation

Week 8

Care Management and Coordination & Transitions of Care & Psychosocial and Behavioral Health & Chronic and Complex Care Management & Legal, Ethical, and Professional Practice

  • Complete a timed full-length practice assessment and score it by domain

  • Review every missed item and write the underlying concept, not just the correct answer

  • Re-drill the two weakest domains with targeted review

  • Rehearse the exam-day plan, including pacing and how to approach scenario questions

Your checkpoint

A scored practice assessment with a written error log and a prioritized list of the three concepts to review last

Milestones

Week 2: Can produce a complete, measurable care plan from a case vignette without notes

Week 4: Scores at least 70% on a domain-1, domain-3, and domain-5 practice set

Week 6: Can explain, in writing, how to evaluate a case management program and which measures to use

Week 8: Scores at least 75% on the full-length practice assessment with no domain below 65%