Q&A: Case management roles in the ED

Q: How do ED case management roles differ from those on other units?

A: Case manager RNs or SWs are usually assigned to specialty units or populations (e.g., trauma, spinal cord injury, orthopedic, acute rehabilitation, transplant, oncology, clinical trial, pediatrics). Their duties may be different than those of their case manager peers on other units, including:

• Reinforcement of standards of care and delivery of core measures
• Development of a very thorough and comprehensive discharge or transition plan
• Participation in physician and staff “grand rounds” and scheduling of conferences
• Teaching a presurgical class to persons who are anticipating an elective admission for the event
• Teaching and guiding the interns and medical students
• Directing the therapy staff to the appropriate durable medical equipment or medical supply provider or vendor for the ordering of appropriate supplies from the patient’s insurer or third-party payer and ensuring the use of the right contracted or network provider or vendor and any specific requirements, limitations, or exclusions of the patient’s specific insurer or third party-payer
• A thorough knowledge of specific forms the hospital might issue to the patient or family (i.e., Physicians Orders for Life-Sustaining Treatment, advance directives, informed consents) and then being available to answer any questions that might arise from the patient or family
• A thorough knowledge of community, local, statewide and national resources, agencies, providers, or vendors as well as public entitlement programs and patient eligibility and referral requirements for the specialty provided to the patients
• More frequent “huddling” with the multidisciplinary care team, with huddles occurring several times per day or week
• SWs may provide coverage of both a specialty unit and the related specialty clinic, offering much-needed continuity of relationships
• Participation in research and other projects

For more information, see The Hospital Case Management Orientation Manual.

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