Q&A: Patients unwilling to accept resources

Q: What strategies can a case manager use to reach patients who are unwilling to accept resources?

A: Below are some  tips and strategies that you can apply to some of your more challenging cases:

1. Utilize peers. “What we have been learning over the past few years with the peers, whether they be substance abuse or violence peers or others, is the age-old knowledge that the best person to understand our patients and help them is someone who walked in those same shoes,” says S. Diane Iverson, RN, BSN, BS, ACM, CCM, a case manager at Johns Hopkins Medical Center in Baltimore. “The healthcare system has always known that a breast cancer survivor can best help a breast cancer survivor, and other diseases are the same.”
2. Be clear and relatable. Providing culturally competent care is crucial in reaching patients who are reluctant to accept help. Making sure the information you provide is relevant and understandable to the person you are speaking with can help encourage compliance.
3. Let patients define their own goals. When patients set their own goals, they’re far more likely to comply and accept resources than they are when goals are imposed on them.
4. Identify barriers. In the Violence Prevention Program at Johns Hopkins, patients often have a history of trauma and may fear violent retaliation. Both raise the risk of future problems. By adopting strategies to address those two significant barriers, the program is more likely to make a difference. 
5. Measure success individually. When working with challenging patients, don’t always use traditional measures of success. “We need to acknowledge patients for whom progress is measured in smaller increments and who respond best to individuals,” says Iverson.
6. Address health literacy. If patients don’t understand the importance of follow-up care, they are less likely to comply. Take the time to make sure they understand why the follow-up guidelines exist and what they will prevent.

For more information, see Case Management Monthly.