Hospital administrators often look at case managers when a patient stay exceeds targets. Length of stay is seen as case management’s responsibility—even though the factors that extend patient stays are often out of their control.
A case manager in an ICU at a metropolitan hospital with a large tertiary patient population is tasked with decreasing ICU length of stay by increasing transfers from the ICU to the postacute setting, such as long-term care hospitals or acute rehabilitation facilities.
The Case Management Society of America (CMSA) has some advice for you if you’re looking to get ahead in your case management career. In a recent issue of CMSAToday, officials encouraged case managers to take a closer look at their personal goals to chart a course for the future.
As you develop a case management program, recognize the importance of clarifying case management and coordination to the provider, payer, and consumer. It is also important to understand the basic and standardized roles of the RN case manager and clinical social worker.
Trauma-informed care is an approach to providing care that recognizes and understands how past trauma—such as child abuse, domestic violence, or events like natural disasters, car accidents, or crime—may affect a person so the provider can respond in a way that promotes safety and avoids re-traumatizing that person.
Some patients seem resistant to interventions aimed at helping them avoid preventable hospital visits. These so-called high utilizers typically have multiple chronic conditions, along with social or psychological conditions and/or substance use issues that can interfere with effective care. AbsoluteCARE, an ambulatory ICU, was created for these patients.
A case manager on a busy medical-surgical unit is facing an end-of-life case. The patient is an immigrant from Chile with limited Medicaid. As the hospital stay continues and his clinical condition worsens, it becomes clear that he has little time left. How can the case manager work with the patient and family to fulfill the patient’s end-of-life wishes?
Case management is a tactical and strategic profession governed by ever-changing regulations. Staying current with regulations is not something a case management leader can do casually or occasionally. The process requires thoughtfulness, broad thinking, and the ability to educate staff and to implement and audit process changes as they relate to new regulations.
