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Speak up: CMSA urges case managers to contact local legislators

You may have heard, but Congress is attempting to enact some type of healthcare reform in the near future. Although the extent of that reform is still up for debate, the conversation about how to improve the current healthcare model is not going away.

What better way to celebrate National Case Management Week than to contact your local legislator and tell him or her about how case managers can improve the healthcare system?

Healthcare reform will have a huge impact on the way you do your job, which is why The CSMA Public Policy Committee is encouraging case managers to speak up and share their experiences.

“We want case managers to share their stories with their local legislators,” said Carol A. Gleason, MM, RN, CRRN, CCM, LRC, BCPC Chair of the CMSA Public Policy Committee.

Gleason says she and the committee are not asking people to talk politics, but rather share what works with the current model and what needs improvement. The idea is that if case managers and other healthcare professionals share their wealth of knowledge with lawmakers, who have likely never worked in a hospital, than our government will be better equipped to create reform that works.

You can also think of it as another form of patient advocacy. Case mangers know how the system affects certain populations because they deal with difficult case everyday. This is a chance to tell the story about the time it broke your heart to tell someone, “I’m sorry but that’s just how the system works.”

The Case Management Model Act

The public policy committee has also created a Case Management Model Act which defines the case management role and explains how the case management principles can be the building blocks for successful healthcare reform. You can download a copy of the Model Act at the CSMA Web site. While you are there, check out the sample letter you can send to your representative and the list of talking points you can use to call him or her directly.

Clinical Social Worker (CSW) or Registered Nurse (RN)?

Effective working relationships between nurses and social workers are the foundation of effective patient care management. Both disciplines bring value and there own unique perspective to the patient/family situation. But philosophical differences, and unclear role delineations can sometimes disrupt collaboration among the two.

HCPro has offered two audio conferences devoted to this subject. Where do you sit on the case management spectrum? Are you an RN or a LCSW?

CMW Tip of the Week: Case managers and core measures

This week’s tip, an “Ask the Expert” is provided by June Stark, RN, BSN, MEd.

Q: What role does the case manager play in coordinating and implementing core measures?

A: The primary barrier to having a case manager in this role is that it adds yet another responsibility to an already overburdened caseload.

If a case manager accepts the responsibility of becoming involved in the core measure process, this should not mean he or she becomes the leader of the project or carries out the core measures at the bedside. Instead, the case manager performs what is called “the sweep,” which is a final review of a patient’s chart.

This is the last opportunity to make sure all the core measures have been carried out and documented by the staff nurses and physicians throughout a patient’s entire hospital stay. In essence, the case manager has the final word on the completion and documentation of the core measures.

Have a tip or tool you’d like to share? Or maybe a question for our experts? E-mail it to editor Julie McGinley at jmcginley@hcpro.com.Your thoughts could be featured in the next issue of Case Management Weekly!