2023 National Case Management Week Giveaway

What three things should you always keep top of mind when guiding clients through the current healthcare system? 

1) Advocate for the patient . Always advocate for our members and their best interest, ensuring they receive appropriate care.

2) Communicate effectively with our members, ensuring that they understand their diagnosis the providers plan of care and their benefit plan.

3)Promote collaboration of care by coordinating with all the providers involve and ensuring that member understand their options on providers plan of care.

What three things should you always keep top of mind when guiding clients through current healthcare system?

1. Always put yourself in the patient's shoes. What would they need to know about the healthcare system that would relieve their anxiety? What information and knowledge do they need to ease their fears about entering a health care entity or doctor's office? 

2. Evaluate their system for documenting their doctor visits, their lab work, their appointments, their questions.  Do they have access to the hospital portal system? Do they write down everything at their doctor visits or take someone with them to their visits? Do they have the ability to be their own patient advocate and if not do they have a designated person to assist? 

3.   Are they aware of their the benefits of their health plan,  contact numbers of their plan,  in network providers and understand their copay responsibilities so there are no surprises and to eliminate stress?

First, I need to say I am a CM with an insurance company. I have a caseload of elderly members with DM, CHF, HTN, Afib, and COPD. 

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

I remember personal things they have told me in the past. I ask about something personal they have told me in the past, for example- how is your son you were concerned about?  I believe that they need to be helped through the healthcare system but they need to know that they, as a person, are important as well.  I work with mainly elderly high-risk members (multiple co-morbidities), I learned through COVID shutdowns that 1. most were afraid, lonely, and enjoyed my calls. 2. if I leave the conversation open and the member trusts me then they tell me medical information that I may not have known. 

What three things should you always keep top of mind when guiding clients through the current healthcare system?

1. Educational differences in people

2. Most people especially the elderly don't understand medical terms. If they are having a procedure or test, I ask what do you know about it? Do you have any questions or concerns? A lot of times the doctor tells them you need to have this test or procedure and they don't understand why. 

3. Educate on the importance of medications, explain why it is important to take them, side effects, and diet.  I find people know they take a BP pill but they don't know to take their BP before the medication, or what symptoms to look for to tell if their BP is low or high. Elderly people usually don't want to call the provider, but I happily call while the member is on the call to hear the questions I ask. 

In a few words, tell us how today's case manager can become a change agent within their organization.

Do your job like you would want someone to treat your family. I believe the good you do for your members will show in how well you are doing your job. 

What three characteristics do you think are most valuable for those considering a career in case management?

Compassion, honesty, enjoy helping others, seek updated educational information for your area of practice. 

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

Meet your patient where they are - identify needs, barriers, be able to communicate to them that you are not just a voice but someone who cares about their health.  I had a cancer patient that had to leave her animals behind to go stay with her sister and she was very concerned about having to take them to a shelter.  They were all rescues and she loved the so much.  This was something that was constant in our conversations.  So, I found some resources for her where there were people that could take them in while she underwent her treatment.  It worked beautifully.  The pet sitters would keep her up to date on how the animals were doing and send her pictures.  During the follow up, the patient repeatedly told me how grateful she was for the assistance with the animals because that was one less thing she had to worry about and she could relax and get through her treatments so she could get better and be reunited with her fur babies. . 

What three things should you always keep top of mind when guiding clients through the current healthcare system?

Communication - be a good listener to their problems/concerns and make sure you understand what they need and are trying to express to you.

Empathy because they don't understand the system and feel they have no voice in their care.  Let them know how you can assist them and that you are available to help them. 

Advocate for the patient. There are resources available that patients are not aware of. Take an active role in their care speaking with their providers for a continuum of care.  

In a few words, tell us how today's case manager can become a change agent within their organization.

Anticipate the needs of the patient and do what is best for them.  Remember their patient rights and that they have a voice in their own care.  Be aware of cost management needs and provide ample education and resources for them.  Makre sure the patients understand your capabilities and how you can assist them. 

What three characteristics do you think are most valuable for those considering a career in case management?

Compassion and empathy - they may be going through many situations that are burdensome to them. It is important to show you have compassion and empathy and that you are there to help them with whatever resources are available. Be willing to listen to them and identify areas that you can assist with. 

Critical thinking skills - assessment skills, adapting to changing needs and level of care, create a plan of care that is unique to that person which aids in making informed decisions. 

Be an advocate for them - think outside your box.  Use the resources available to you, research resources, collaborate with peers and providers and be a part of their treatment plan.  

Easy. You live in their world, what they believe. Do not argue or try to bring them back to your reality. My mother has dementia, I am her POA. I agree with her. I also have stage 4 lung cancer ♋️. She says she has a new vehicle, I say cool , can't wait to come get you to spend one night in her home of 67 years. She raised all her children there. We lost our sister, my mothers first child, born on her birthday. I deserve this for the sadness we have had and have more to come. I pray I live, so she does not endure losing another child. My sister passed from ALS.  My mother never forgets that. She deserves this. She raised 4 children in her home that unless I am there she doesn't get to go to. I lived through this with my Dad, now my mother. I certainly know how to deal with this. If it is not a danger, they are right. Again, you live in their world. 
 

Lesa Denise Bedwell BSN RN CCM

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

As a case manager,  I want to show utmost respect for those I serve allowing for self-determination and meeting my clients where they are.  I care about those who I serve.  They are the reason I do what I do.  What is the purpose of my role as case manager if I am not putting my clients at the center of attention and ensuring their care matters? 

1.     What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

Act as a member advocate to promote and coordinate the delivery of quality and cost-effective healthcare services based on medical necessity and contractual benefits.

2.     What three things should you always keep top of mind when guiding clients through the current healthcare system?

·      Case manager incorporates the clients input into the care planning process.

·       Facilitate and coordinate the delivery of care across the health care system.

·      Coordinated with providers and consumers to support the delivery of high-quality care across the health care system.

3.     In a few words, tell us how today's case manager can become a change agent within their organization.

Today's case manager becomes a changed agent in their organization by collaborating with other interdisciplinary and guiding the member through the health care system with the goal to provide quality of care, effective cost findings, and best outcomes.

4.     What three characteristics do you think are most valuable for those considering a career in case management?

The case manager

1.     Demonstrate commitment to the case management process.

2.     Be accepting of racial, cultural and social economic differences.

3.     Be motivated to know and understand Professional and Ethical Principles that align with the case management profession.

Case Management Questions.docx

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

Active listening is the most important thing you can do for your clients/patients/participants. Active listening shows the person that you care, and understand. Communication coupled with active listening allows for optimal interactions with your patient/client/participant. You must be available and fully committed to listening and responding to the person as they speak. You also have to be able to speak to the person on their level of communication and convey information so they are able to understand. This allows you as a case manager to provide the most effective care for the client/patient/participant. 

1. What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

The most important thing I do as a case manager to show those I serve that they are at the center of care is to listen and let them know you are here to help. In my experience, the clients simply need a friendly ear and someone to know that they need help. The clients need to be aware that I am here and available to support them. Sometimes, when I encounter a client and initially there is no need, I provide them with my information so that they know that I am available when a need arises. By listening and making them aware of your presence, they can feel that there is care involved and they are not alone.

2. What three things should you always keep top of mind when guiding clients through the current healthcare system?

The three things that a case manager should keep in mind when guiding clients through the current healthcare system are to keep in mind firstly that the healthcare system is a complex system. One must know how to communicate with other departments and have an interdisciplinary team involved if applicable to the member's concern. The second is to remind them that they can ask questions. Ask questions to the provider, their nurse, the medical team, and even other personnel that are involved in their care. If they feel that the explanation is not clear regarding a concern, then please ask questions. If you need to write down your question to your doctor to help you remember, then do not be shy and do it. Third, have a good record system. If the client has access to the Electronic Health Record (HER) then create a folder of their downloadable visits. If they are handed a paper copy of their documents, keep it in a safe place.

3. In a few words, tell us how today's case manager can become a change agent within their organization.

Case managers can become change agents within their organization when they listen to the member's concerns and stand up for what is right.

4. What three characteristics do you think are most valuable for those considering a career in case management?

The three characteristics that are most valuable for those who are considering a career in case management are, first, being resilient. Your ability to stand up after a tricky situation is important when you are assisting people who are in need of case management. The second is patience. This will go hand-in-hand with resiliency. All of the time, as case managers, we have to be patient to assist the members, help them navigate their health, find the best possible solution, and stand up for what is right. Third is resourcefulness. Answers may not be immediately present in front of us as case managers. Sometimes we have to improvise and be spontaneous to provide care and obtain answers to help members. These qualities would help anybody who wants to become a case manager.

What is the most important thing you do as a case manager to show those you serve that they are at the center of care? I place my clients at the center of decision making and  ensure that they are actively engaged in the  process so be sure that all aspects are identified that may impact care.

What three things should you always keep top of mind when guiding clients through the current healthcare system?

Cost- Services -Alternatives

Finances - Available and other resources

Social factors 

In a few words, tell us how today's case manager can become a change agent within their organization.

By using active listening that will guide you to the patient's needs.  Every situation is different and  you can not always apply the same  remedy. Be that advocate and active voice for their needs.

What three characteristics do you think are most valuable for those considering a career in case management?

Compassion

Passionate

Resourceful 

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

I take the time to sit down in a chair next to the patient to build a connection with them by getting on the same level with them. This also conveys that I am here for only them and am not trying to rush off to do the next item on my list. I actively listen and then provide options that meet their needs to help build a plan that is both safe and tailored to their needs.

What three things should you always keep top of mind when guiding clients through the current healthcare system?

1) Do not assume that the patient understands their benefits through their payer.

2) Patients may be too embarrassed to let the doctor know they don't understand what is going on with their care. Take the time to ask if they have questions and understand what the next steps are.

3) When working on a discharge plan, try helping the patients remember the some of the details such as if going home after a procedure, where are they going to sleep, how are they going to get into the home, who is going to help them with meals/shopping. Patients want to go home and do not necessarily think of the basic needs.

In a few words, tell us how today's case manager can become a change agent within their organization.

Hospital case managers are always in the patient's chart. They can identify trends with potentially unsafe practitioners, and they can identify areas of improvement with the nursing process. By speaking up and documenting these, it can help with process improvement within their organization. Case managers are always a second set of eyes within the patient's medical care and can impact better quality care.

What three characteristics do you think are most valuable for those considering a career in case management?

1) Humility- case managers do so much behind the scenes for their patients.  They find things that providers/floor nurses may miss, they battle with the insurances, they advocate for the proper discharge plan, etc. The majority of the time, all of those efforts go unrecognized.  If you are looking for praise and affirmation, do not become a case manager.

2) Tenacity- case managers need to be tenacious when advocating for their patients whether it's working on appealing a denial with the insurance, advocating on the patient's behalf when they are at odds with what their family wants, speaking up to the doctor when the plan doesn't align with the patient's wishes.

3) Kind- case managers need to show kindness when dealing with patients who are not well and have that loss of control.  Kindess to the family members who are grieving a potential loss of loved one. 

1) What is the most important thing you do as a case manager to show those you serve that they are at the center of care? A - Listening  B- repeating their statements to verify you understood.  C. Always summarize your discussions so they know what you are going to do and what THEY need to do.

2)What three things should you always keep top of mind when guiding clients through the current healthcare system? A- Allow them to maintain their control over the situation    B- Give them options    C- When they decide on an action - have them tell you why they chose that.

3)In a few words, tell us how today's case manager can become a change agent within their organization.  A- Stay up to date!   B- Learn from lectures  C- Put things you learn into practice             D- Don't be afraid to speak up. If something is off - then let them know it. and of course praise and agreement means a lot to people

4)What three characteristics do you think are most valuable for those considering a career in case management?    A- good documentation skill   B- Ability to built rapport quickly with clients/ Physicians etc.   C- Organization skill   C- Know that in some CCM jobs you never get to meet your "client". If you are a people person and need that type of contact, you may not be happy working from home.

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

Listen to their needs

What three things should you always keep top of mind when guiding clients through the current healthcare system?

it can be confusing

don't assume you know what they need 

listen more than you talk 

In a few words, tell us how today's case manager can become a change agent within their organization.

growth mind set, challenge assumptions and old ways of doing things, lead by example 

What three characteristics do you think are most valuable for those considering a career in case management?

it is more than just a job, caring & compassionate for all humans 

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

I always use H.E.A.R.T

S.T.A.R.T. with Heart

Smile and greet warmly I am a telephone case manager and I try very hard to have a smile on my face when I am talking to my clients It comes thru in your voice if you have a smile on your face
Tell your name, role and what to expect
Active listening and assist
Rapport/relationship building by building a relationship with my clients, I am able to show I care about them and will help them achieve their goals.
Thank the person

Respond with H.E.A.R.T.®

Hear the story
Empathize
Apologize even if I am not at fault. I want them to know I hear there frustration with what ever is going on.

Respond to the problem Offer to resolve concerns or forward to the appropriate person

Thank the person

What three characteristics do you think are most valuable for those considering a career in case management.

I feel the most important thing a case manager can do is involve their patients in the care plan. It's their decision on where they go and if they accept the care provide. Everyone has a different world view and we need to make sure that patient centered care is provided. It's not one size fits all. There are many diverse backgrounds, cultures, and religious and beliefs that are at th center of the patients decision and we need to respect their wishes. 

Also we need to offer all possible scenarios and educate them on what is and. What is not realistic. Often people are misinformed or mislead into believing one set of thoughts when on fact that is not actually the case.  Being straightforward and honest is the best policy.

#1. What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

In addition to providing patients the information they need to navigate their care, I empower them to advocate for themselves and ask questions. I clearly position myself as their teammate, which gives them confidence in navigating complex systems and conversations.

#2. What three things should you always keep top of mind when guiding clients through the current healthcare system?

1. Not all doctors have the same recommendations - second opinions are allowed!

2. Show up for your appointments. Our healthcare system is at capacity right now, and delays in appointments will mean delays in care.

3. Ask questions! Sometimes it is assumed that patients understand certain counterintuitive processes - do not be afraid to ask.

#3. In a few words, tell us how today's case manager can become a change agent within their organization.

Because the Case Manager builds relationships with so many different individuals and organizations, they have a uniquely well-rounded view of systems and how to navigate them. This gives Case Managers a perspective that allows them to identify and implement big-picture changes that can make the biggest impact for multiple parties.

#4. What three characteristics do you think are most valuable for those considering a career in case management?

1. Flexible.

2. Organized and able to prioritize!

3. Empathy and patience. 

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?  

I believe that listening to hear (verbal and nonverbal) rather than listening to respond is the single most important skill used in my work as a case manager. This helps me engage with my clients where they are and address their concerns before covering other topics.  

What three things should you always keep top of mind when guiding clients through the current healthcare system? 

Navigating today's healthcare system is challenging, even for case managers who do it routinely; empathy for the clients we serve is imperative. Our role as case managers and change agents is to empower our clients to be their own advocates for their healthcare. There is value in seeking out the right provider for the right care at the right time whenever possible.  

In a few words, tell us how today's case manager can become a change agent within their organization.

Today's case manager can influence change within their organization in the same way that we influence change within our clients; by providing a prospective that adds value to the intended outcome. It can also be stated more simply by saying that the case manager can appeal to the greed of their organization (ie: cost savings, increased productivity or revenue, ect).  

What three characteristics do you think are most valuable for those considering a career in case management? 

I think that it is essential for a case manager to be compassionate, to believe in autonomy, and to understand that importance of self-care.  

What is the most important thing you do as a case manager to show those you serve that they are at the center of care?

As a case manager, the most important thing I do is to build a strong connection right away with my patients and letting them know that I am their advocate and partner in care. They can put me on speed dial as their direct contact for any of their health needs or concerns; I go into action immediately to serve my patients to prove reliability and accountability. I always ask for their input and goals, summarize and agree on next steps so my patients are always aware of the collaboration or care coordination that's happening outside of the office/clinic walls and their routine visits to the doctor. I maximize the help they can get my being up to date with available resources and facilitating linkage to those resources. I am the middle person that keeps everyone on the same page including the patient and all the healthcare providers or other disciplines involved in the patient care.