Case managers may not be physicians, but they are still integral to the quality of patient care. Regardless of whether a case manager’s role includes clinical or medical case management, utilization review, discharge planning, or a combination of these and more, if the case manager can advocate for the patient during the medical encounter, he or she can influence good clinical care, says Jackie Birmingham, RN, MS, clinical leadership at naviHealth: A Cardinal Health Company, headquartered in Brentwood, Tennessee, and author of Discharge Planning Guide: Tools for Compliance, Fourth Edition.
Let's look at one specific area where case managers can make a difference: reducing hospital-acquired anemia (HAA). This condition is often the result of blood draws performed cumulatively—and sometimes excessively—as part of laboratory testing.The prevalence of HAA can be exacerbated by another form of inappropriate medical care—in this case, laboratory tests. The goal is to ensure a patient only undergoes laboratory tests he or she truly needs.
Working in case management for years has taught me to use the ABCs in at least two tasks I perform daily. Not only are the ABCs useful in developing patient discharge plans, but they also help in setting my daily caseload priorities. How do they work?
After a busy week, Gretchen, a manager of case management, is looking forward to the weekend. On Friday night she goes to bed early. By Saturday she still feels worn out, so she sets her cell phone on vibrate. All she needs, she thinks, is more time to recover and regain her energy for the upcoming week.