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The acute care case management model must change

Acute case managers in today's world should be viewed as leaders in the organization

Remember the days when the case management department in the acute care setting consisted of discharge planning and retroactive utilization review? I entered the case management field in the ’90s when it was common practice to work in your own silo. And the lines of communication between facilities or individuals weren’t always open.

This defined case management in the acute setting for many years.

If you’re still in this model, there’s no better time to transition to an updated, outcomes-driven model (that focuses on the big picture) than right now! Your organization simply can’t afford to wait.

As case managers, we must take ownership of the challenge and rise to the occasion, paving the path to better coordination (which ultimately leads to better outcomes). Not only dealing with the acute episode, but thinking about how we position our patients to be as successful as possible when they leave the hospital and transition to the next level.

The IHI Triple Aim (improving the experience of care, improving the health of populations and reducing per capita costs of healthcare) is great news for assertive, proactive case managers who have long yearned for teamwork, and have historically spent the majority of their day trying to figure out the patient’s plan and get team members on the same page – all while engaging the patient at the same time.

This is not-so-good news if you’re a case manager that enjoyed a case management model strictly focused on discharge planning and retroactive utilization reviews. This model and continued mindset isn’t acceptable to produce optimal outcomes in today’s environment.

The acute case manager in today’s world should be viewed as a leader in the organization, who is committed to contributing to quality and financial outcomes.

Having said this, case management departments and personnel must have the organizational support, education, tools and appropriate resources to meet the expectations. Not to mention a shared organizational vision, responsibility for care coordination and the realization that everyone in the organization plays a part in that process.

Organizations must also recognize that case management departments alone can’t solely control metrics like readmissions, length of stay, cost per case, throughput, etc. Care managers can certainly impact and influence these metrics, but need the entire culture to be proactive with a shared sense of urgency to deliver high-quality, cost-effective care.

Teamwork is a beautiful thing! Get your case management in order (if needed) then invite and educate others in the organization to share in your vision for timely, well-coordinated, cost-effective, high-quality care across the continuum! Your patients will thank you for it.

This post appeared first at Action for Better Healthcare.