As Senior Director of Care Management Nursing at Cleveland Clinic, Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC, CCM, is a perfect person to explain the important role of a case manager. Dr. Davis not only describes the responsibilities of a nurse working in case management, but also discusses the future and provides advice.
The decision to become a nurse is one of the best I have made in my life. My passion for Case Management has allowed me to serve patients in their own space, and teach case managers the value of arming patients with the knowledge and motivation they need to navigate a complex health system.
My nursing career has allowed me to work with patients who want to improve their health, their education, and their habitat. I have relied on the foundational work of those nurses who preceded me in practice and academics, including my mother, a Registered Nurse for 60 years.
Case Management is a wonderful career for nurses. You have the ability to provide vital care coordination services within a patient centric plan of care. Case managers help patients understand their diagnosis, options for treatment, and the complex healthcare system. Case managers work in settings across the continuum of care. A case manager may work for a large or small health insurance provider, in workers' compensation insurance with a selected population of patients, or in acute care hospitals, providing support and guidance to patients in the care coordination process. They may work with patients who are designated as high risk, or patients with chronic diseases, such as heart failure or chronic obstructive pulmonary disease (COPD).
Today more than ever, with the change from a fee-for-service to a value-based medical model, and the shift to population health – an approach that aims to improve the health of an entire population – case managers can be the key to success. The unique services a case manager provides are essential to helping patients manage their own health.
Population health models will create extended teams of case managers and non-licensed case manager extenders who will manage large groups of patients. A case manager may be responsible for overseeing patients in different states with his or her team of experts. Telehealth will also play a role in this change, as it will allow the case manager to care for many more patients.
It was my privilege to serve on the National Case Management Society Board of Directors and to serve as the National President. Nurses should join their professional organizations to foster their growth and development in health care policy and patient advocacy. They will also benefit from evidence-based tools and resources.
Case management is a challenging and rewarding field. The nurse case manager has to think outside of the box and explore every possible method to help his or her patients.