Case Manager caseloads

  1. I work for a hospice that has us carrying a 15-17 client caseloads. I drove 555 miles last half and feel that my client are not getting all the attention they deserve. Anyone have any thoughts on this?
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  2. 7 Comments

  3. by   doodlemom
    Quote from ray2512
    I work for a hospice that has us carrying a 15-17 client caseloads. I drove 555 miles last half and feel that my client are not getting all the attention they deserve. Anyone have any thoughts on this?
    Ouch! I am truly sorry for you and your patients. I can't imagine the stress you must be under.
  4. by   CANRN
    OMG!!!!!! I used to work for a hospice that covered like 14 counties. It was nothing to put 300 miles A DAY on my car! and the reason I left was because I just did not feel that I was giving these patient's and their families the proper time and care they needed. Bless your heart! I feel for you.

    I now work for a Hospice that covers the five counties but we are given areas to cover. The only time we are responsible for it all is when we are on call and then the call person has a "helper" she can call if things get out of hand. I love it! Because I know that if I am at a home and they need me to stay for extended time, I can call my helper and our managers will jump in and do visits if we need them also. We work as a team and I can't imagine doing this job any other way.
  5. by   andyg
    I feel your pain!! Our nurses right now are carrying 14-18 patients per case manager but that's because of the amazing growth we have seen over the last four months from adc in August of 92 and now up to adc 115-120 and administration hasn't approved new positions. We have pulled in all part time, registry and weekend nurses to assist with making visits. One thing you might use with your mgt. people is the NHPCO's staffing recomendations on their website, it suggests 8-12 patients per case manager. You didn't say whether this is a constant load or whether your staffing or census patterns had changed. Good luck and hang in there at least these patients are getting some attention even though it may be limited.
  6. by   doodlemom
    Quote from andyg
    I feel your pain!! Our nurses right now are carrying 14-18 patients per case manager but that's because of the amazing growth we have seen over the last four months from adc in August of 92 and now up to adc 115-120 and administration hasn't approved new positions. We have pulled in all part time, registry and weekend nurses to assist with making visits. One thing you might use with your mgt. people is the NHPCO's staffing recomendations on their website, it suggests 8-12 patients per case manager. You didn't say whether this is a constant load or whether your staffing or census patterns had changed. Good luck and hang in there at least these patients are getting some attention even though it may be limited.
    Andyg,
    Could you point me to the exact place of this recommendation? I would like to show it to our new DON so that she can have a better understanding. She has a great deal of nursing management experience but she has no previous hospice experience. We're keeping our fingers crossed that she does not come in and try to change too much!
  7. by   andyg
    doodlemom
    You can find this inof on the NHPCO website, once logged into the opening page go to technical support then go to the 12th bullet, suggested staffing ratios, and there you go. Good luck with your new manager, hopefully she will utilize your nurses expertise and input before making major changes. Andyg
  8. by   sharlyb
    I have worked for two different hospices and I can tell you there is a vast difference between the two of them in terms of skill in management and knowledge of how to deliver quality hospice care effectively. To answer your specific question as to reasonable caseloads, geographical and demographical issues must be taken into consideration. So too acuity levels of patients, degree of neediness of patient caregivers, and location of patients i.e. managing five patients all located on the same floor of a long term care facility is quite different than managing five home care patients who are scattered 20-30 minutes apart from one another. Home care patients generally need a lot more time and attention than a nursing home patient because of the fact that the family are the primary care givers and there is no 24 hour nursing care available to the patient. A skilled team leader will understand these issues. My first team leader did not. It was purely a numbers issue with her- how many patients did each case manager have.
  9. by   doodlemom
    Quote from andyg
    doodlemom
    You can find this inof on the NHPCO website, once logged into the opening page go to technical support then go to the 12th bullet, suggested staffing ratios, and there you go. Good luck with your new manager, hopefully she will utilize your nurses expertise and input before making major changes. Andyg
    Thanks Andyg

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