How a scoping exercise can help determine case management team roles
A scoping exercise offers participants the opportunity to consider the work within their scope of practice. Today, case managers and social workers have become cross-trained in many areas, creating ambiguity about the distinctive education they must use to support patients in different ways. That is, whereas RN case managers understand the medical trajectory and can help patients along the continuum, social workers are trained to manage the social and emotional aspects of their recovery.
A scoping exercise is highly effective in putting objectivity on the table. It encourages participants to consider the best role for each discipline based on the task and educational background of each member. A scoping activity is an excellent way to begin understanding the team members’ roles and responsibilities. It is a great beginning to the overall activity of understanding how the elements of the model change.
The sticky-note process:
- Take each role, one at a time
- Ask the team to write, on a sticky note, every action they are respon-sible for
- On a large poster board, place categories around each activity—one being “out of scope”
- Discuss categories and the definition of out of scope
- Create a category called “take it for the team”—which includes the gray-area activities (otherwise known as an action that needs to be completed by the team but that does not require their education to complete)
- Have staff place their sticky notes under each category
- Determine the roles that are appropri-ate; discuss out-of-scope roles
- For those roles that are truly out of scope, identify what other role in the organization can complete this role or whether it should become a “take it for the team” activity
Example sticky-note categories:
Case manager
- Initial assessments
- Readmission assessments
- Transition planning
- Pacing the case
Utilization management nurse
- Medical necessity surveillance
- Resource utilization
- Status/level of care compliance
Social worker
- Psychosocial assessments
- Crisis intervention
- End of life
- Social regulatory issues
- Psychosocial transition planning
For more information see Care Transitions in Case Management.
Sticky-note process source: Bonnie Geld, MSW. Adapted based on information from Lean Simulations. (2011). The Lean Dot Game—Stick It to the Man! Retrieved from www.leansimulations.org/2011/10/lean-dot-game-stick-it-to-man.html.