DorlandHealth

Case management practice continues to be a hot topic as healthcare reform takes center stage over the next few years. As dynamic as it is, the healthcare arena abounds with opportunities to advance the practitioner’s knowledge, skills and opportunities. As a result, case managers will need to seek advanced education in order to provide a more robust and coordinated care effort. The idea that case managers seeking upward mobility would be the only individuals who need more education has completely changed to include those in frontline positions in different settings throughout the healthcare continuum.

Regardless of care settings, patients today require a case manager to have advanced skills in order to maximize the utilization of resources that are constantly shrinking. It is not uncommon for a case manager to have a patient with limited resources, be it financial or social, and also to be faced with the aspect of helping that patient manage their chronic illness or the crisis of a new diagnosis. Today’s case manager requires not only a clinical background but also an understanding of the financial and psychosocial aspects that affect the patient, the continuum of care and the patient’s ability to navigate through the healthcare maze.

Pursuing advanced education within the field of case management has many benefits that affect not just the case management professional but also affect the diversifying patient population we serve. Patients’ cultural, social and economic diversity can affect how care is received and may dictate how care should be provided. Medical providers cannot simply take the approach of providing clinical care without consideration of the elements that make patients the individuals they are. Exercising a purely physiological model of healthcare provision would be doing the patient a disservice. As case managers, we must take into consideration the individual and their immediate system in order to determine the most appropriate plan of care. As we obtain advanced education, we learn of ways to most positively impact the patient’s outcome.

Dually Empowered

Case managers who are looking to move into leadership positions will also need to obtain advanced education in order to meet the minimum qualifications in certain practice settings. For example, many acute care hospitals require a graduate degree as a minimal requirement in order to apply for leadership positions. This attests to the fact that advanced education is equated with the acquisition of knowledge, skills and cutting-edge information that can help move the healthcare organization ahead of the pack in a highly competitive market.

There are many accredited universities offering online courses. Case managers today can seek advanced education through online graduate programs in case management, healthcare management, business administration and nursing. This affords the case manager the ability to continue working full-time without having to attend courses in the traditional brick-and-mortar classroom setting. Case managers pursuing advanced education are providing a benefit to healthcare organizations, their communities and to their patients.

As we consider the benefits of advanced education to our patients and to our healthcare organizations, we should also consider the attainment of personal empowerment for the case manager. A case manager who is empowered is one who is invested in the profession and one who believes she has the ability to make a positive impact for patients and a positive impact on healthcare outcomes. The flip side of such empowerment is helping the patient to feel empowered as well. An empowered patient is one of the highest rewards of the case manager’s practice. It is often easy to assume the responsibility for the patient rather than to allow the patient to take ownership of his care. The benefit of advanced education for the case manager in such cases is the attainment of knowledge regarding various aspects related to care such as human behavior, healthcare system operations and community resources. Armed with this knowledge, the case manager can, in turn, arm the patient with the information and resources to be a contributor to their own care, resulting in a healthier, more empowered patient.

As case management professionals, our ethical responsibility lies within assisting the patient to assume a sense of self-determination and to provide them with the tools to help them “find their way” in what can be a daunting experience in our healthcare system.

The take-away message is this: advanced education of the case manager results in positive outcomes for the case manager, for the patients and for our healthcare system.

Jose Alejandro and Betty Thomas are doctoral students at Capella University.

The Importance of Verification During the Credentialing Process

Case management leaders across the continuum of care strive to provide the highest level of quality healthcare services. When multiple providers and ongoing care transitions are involved there must be complete confidence in the credentialing of the varied providers.

Do you always know if the person in the next cube working with patients is a licensed or certified professional? Do you know if the doctor that is working with you and the patient is a licensed healthcare professional? Does it make a difference if the healthcare professional is licensed or certified? Should we be concerned for our patients’ safety?