Hi, I'm Jessica Spellman and
we're gonna be reviewing Case Management.
The objectives of this course is that you'll be able
to understand the definition of case management
and identify the role of nurses
in case management in the clinical setting.
So let's start with what the definition of case management is.
It's the coordination of services
specific to a patient and
it's provided to all patients in the hospital,
whether they're going home, whether they're being discharged
to rehab or they're going to an extended care facility.
It includes the coordination of resources,
such as home health, durable medical equipment,
transportation to and from appointments,
laboratory services etc.
A question you may be asking yourself is:
"My employer has a designated Case Management Nurse.
So why do I need to know about case management?"
Case managers are important part of the healthcare team.
They work with physicians, nurses, physical therapists.
So everyone needs to be knowledgeable
about the role the case managers
play in patient discharge. So
it is important that nurses understand
the role the case managers play.
And the role that they play is that
they assess and identify patient healthcare needs,
they seek available treatment options and
how to meet those needs after discharge;
they coordinate services and they educate patients
and families about those services.
So case management uses a specific set of
characteristics in order to be successful.
Case managers need to have good
communication skills, very compassionate,
the ability to think analytically,
good knowledge of the healthcare system and insurance,
knowledge of specialists
and primary care physicians.
They need to collaborate with other disciplines and
need to be good with problem solving skills.
So one of the main things that case managers do is make referrals.
Within the hospital setting, they may make referrals to
physical therapy, occupational therapy,
nutrition counseling. Again,
referrals are always patient specific, so it could be
a mixture or coordination of any of these services.
They also assist patients in finding
primary care physicians or specialists
upon discharge and they locate rehabilitation
extended care and home health care facilities.
Discharge planning is another role of the case manager.
They assess clients for their healthcare needs
in the hospital setting and after discharge.
It begins when the patient is admitted
not right before they go home. It can take a while
to coordinate services, find placements in extended care facilities
rehab facilities, have durable medical equipment delivered.
So that needs to start when the patient is admitted
and anticipating what they might need upon discharge.
They work with all
disciplines to ensure a holistic plan of care.
So they also teach clients, they assess patients and families
for what they need information about,
they identify the areas of teaching,
they work with physicians and
collaborate with other disciplines
to make sure teaching is complete.
Nursing does a lot of the teaching for discharges
and needs to be able to work with the
discharge planner in order to get information
gathered for the patient prior to being discharged.
medication administration education,
safe use of durable medical equipment,
maybe by physical therapy,
exercises for physical therapy, and nutrition
counseling for specific conditions
like diabetes or heart failure.
Durable Medical Equipment.
If you're going home with Durable Medical Equipment,
a case manager is gonna be working with the nurse and
the healthcare team to determine what type of Durable Medical Equipment
and to arrange the delivery and setup
of the Durable Medical Equipment needed.
They also identify follow-up and physician appointment needs,
sometimes even set up the appointments,
provide transportation to and from when
that's not available to the patient
in order to help them keep scheduled appointments.
Case managers are responsible for collaboration
of the entire healthcare team,
to make sure patient needs are identified and addressed.
They work with the attending physician, the specialist,
the therapist, nutritionist,
pharmacist, and others as identified.
So in summary,
case management is the coordination of
patient-specific healthcare needs
in a variety of settings. It starts on
admission to the hospital and is ongoing.
It involves all disciplines.
It involves using great communication skills
and collaboration along with problem solving
in order to create positive patient outcomes.
And specific duties include setting up referrals,
working on discharge planning,
and educating patients and families
about their needs when they go home.
This has been Case Management with Jessica Spellman.