Q&A: Case management scheduling and coverage
Q. Does case management need to be a seven-day-a-week service, or can the service succeed with coverage five days per week? As a case manager, I need to retain staff but also provide some consistency to the patients.
A. This seems like a matter of “good news, bad news” in that the more it is perceived that case management is necessary, the greater the expectation that it will take the lead as a 24/7 service, even if other departments are closed. As far as internal considerations for coverage, the following list, generated by a case management staff member, identifies reasons that case managers and social workers (in a system that owns the transitional care unit [TCU] and home care) could not succeed in decreasing length of stay (LOS). They also did not see a need to cover weekends or extend into evening hours:
- No physical therapy (PT) after 3 p.m.
- No TCU after 4 or 7 p.m.
- No home care referrals or services after 4:30 p.m. or weekends
- No post-anesthesia care unit after 5 p.m.
- No backup heart room for catheterization
- No nutrition services after 4 p.m.
- No ECHO or stress techs after 4 p.m. and weekends
- No nuclear medicine
For more information, see Case Management Models: Best Practices for Health Systems and ACOs, Second Edition.