Q&A: Case management teamwork across the continuum

Q. How can case managers improve teamwork across the continuum of care?

A. A great method of team-building is to develop 90-day care plans with representatives from post-acute care, including community agencies. Another method is to have the team itself evaluate the degree of teamwork they perceive. Yet another method for building teams is to have a description and direction to team-building.

The Center for Case Management, Inc., has developed “Cue Cards” to handle sticky situations with fellow professionals as well as patients. The goals of the Cue Cards are to give you more time to think, to keep you patient/family-centered, and so you can “get to yes” before you are totally backed into a corner. The other goals are to keep you from saying things you might like to say to each other and patients, such as “In your dreams, dude,” “Read my lips,” “It’s a miracle you got this far!” “Maybe you could do this better,” and “My people will talk to your people.”

The majority of responses are about team-building, such as “I need your help,” “We are a team,” and “I am sorry.” Others are supportive as well, such as “It’s your right,” “What am I missing?” “Let me look into that,” “I hope so, too,” and “What would it take?”.

For more information, see Case Management Models: Best Practices for Health Systems and ACOs, Second Edition.

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