Case Manager in the ED?

Yep - we do. I work in a 500 plus bed level one trauma center (63k visits/yr). Up until two months ago, I was a full-time case manager in the ER. We did more discharge planning versus admissions in our ER. We did a lot with habitual patients and getting them access to care. If you would like more info, just PM me.

ED case management is something the hospital I work at is piloting for the next few months. I have already seen an impact on arranging transportation and helping speed up the flow. We have shown administration how we can have an impact in quality outcomes, but it has fallen on deaf ears. I hope that we will see some financial outcomes (appropriate admission status, decrease ambulance diversion time and a decrease in the return rate) to support getting the position approved.

This is becoming a trend nationwide to have CM's in the ED. The rationale for such positions is to help ensure that those admitted meet criteria, thus reducing inappropriate admits, verify insurance coverages, etc. Our hospital is considering this at this point in time.

Morghan, MSN,ARNP

We have an ED case manager. This is an effective position for our hospital. The CM ensures that pts are admitted correctly....not admitted un-necessarily. She also handles the community assistance as needed---ie, home health, NHP, DME, transportation.

When I was working as a Case Manager in FL in 1995; I split between the ED & Behavioral Health. I think it depends on the "role" you establish for the Case Manager. We were the first in my community to utilize RNs and it was a conflicting job to have as I would work as a discharge planner as well as utilization management. So from an ED point of view; a patient is admitted and has some type of VA insurance and we would have to determine if the VA would pay for the first day and then transfer or just tranfer asap as the hosipital will not get paid. It was also hard as I worked in the ED and when you are waiting for the CM to make arangements which can be time consuming you have a bed that you need to fill. I am not sure if you ever felt this but just a little communication would be helpful so you know what is going w/ your pt in the ED. If in doubt as to what they are doing....just ask. Prior to RNs it was the social workers doing d/c planning and a team of nurses doing utilization role.
Monnie RNC,BSN

I'm poster #4 above, and it appears I may be tapped for this new ED position I was talking about earlier. Any pitfalls-barriers-problems with the docs, etc. that cropped up. Just inquiring minds want to know.

Case Manager -Ks