The clinical side of case management

In this guest post, Bonnie Geld, President and CEO of The Center for Case Management, explains why the clinical aspect of case management is so critical to patient care. With over 20 years of experience in the field, she offers a unique and valuable perspective on how case management improves outcomes. Bonnie will join us for a more extended conversation during our upcoming thought leadership webinar on September 20 at 1 pm ET. Save your seat today! 

When we made the decision to become nurses and social workers, we certainly weren’t driven by the desire to complete forms and applications, set up rides, fax documents, answer phones, and deal with the myriad other logistics that go into delivering a continuum plan. We went into healthcare to make a difference in peoples’ lives.  

But over time, many of us have let tasks like creating discharge plans and completing UM reviews take precedence over clinical planning and assessment. While managing the logistics of care is important, a sustainable care plan can only be achieved through using clinical skills and knowledge to address each patient’s medical and emotional needs. 

It is in our role as clinicians, not administrators, that we will best understand our patients, have the opportunity to guide the team toward a realistic plan, and be able to intervene early to overcome the challenges and obstacles that are unique to each patient.   

It is essential that case managers, who know the “whole story,” help move the patient along to a setting that will continue to sustain their recovery and/or care or move the care along to the next appropriate provider. Hospital case managers must think 30, 60, and even 90 days beyond the hospitalization, and ambulatory case managers must think throughout the course of treatment and/or the trajectory of chronic disease.  

Here are five ways that case managers can embrace their clinical side and influence patient outcomes. 

5 Keys to Influencing Outcomes with Case Management  

1. Assessment:  Without a strong clinical assessment it is likely that complex patients will reveal barriers to the plan at the end of or even after an episode of care.  A strong case management or psychosocial assessment, on the other hand, leads to a realistic, sustainable plan.  It is the beginning of the patient relationship and will reveal more and more information over time, benefitting both the patient and the interdisciplinary team. 
2. Alignment: There is the perfect plan for the patient and then there is the realistic plan for the patient. With their unique knowledge of the patient, case managers and social workers are positioned to guide the team toward the latter and ensure that the patient isn’t set up to fail. They can use their clinical skills to view the plan through the lens of all providers, as well as nurture the plan to meet the needs of each patient within his or her capacity to recover.   
3. Patient Engagement:  All providers, including case managers, must seek to engage the patient in the plan for recovery and sustainability. Case managers build strong patient relationships through their clinical assessments and by spending enough time with the patient to understand their specific needs and encourage self-management. 
4. Disease or Emotional Trajectory:  In order to support the goal of sustaining optimal health, case managers must understand the trajectory of the patient’s medical condition, as well as the patient’s emotional capacity to adjust to changes.   
5. Course Correction: Case managers and social workers have the unique capacity to recognize subtle changes and proactively work with the patient, family, and interdisciplinary team to keep the patient on the path to self–management, adjusting the plan as needed along the way. 

Join me on Thursday, September 20 for a more in-depth conversation about case management, covering a range of topics from payment models to patient engagement.