Case management a rapidly growing role despite pandemic difficulties

A patient’s short- and long-term treatment options are almost at all times coordinated by a dedicated nurse. During the COVID-19 pandemic, case managers took on much more essential and visual roles as hospitals and healthcare facilities struggled to navigate uncharted territory. They have played an integral role in ensuring that existing procedures work as intended and that latest protocols are followed and meet the needs of enormous, diverse patient groups. The obstacles health care employees in virtually every setting faced firstly of the pandemic are actually well documented. Case nurses were actually no exception. For many case managers, “it was a baptism by fire,” said Catherine M. Mullahy, BS, RN, CRRN, CCM, FCM, president of Mullahy & Associates, which provides continuing case management education, certification preparation, training and support. “Everyone was under pressure to do more with less and work in an extremely tense environment with so many negatives swirling around every decision,” she added. Mullahy, together with Jeanne Boling, RN, MSN, CRRN, CDMS, CCM, FCM, vp of Mullahy & Associates, can also be the creator and instructor of Nurse.com Best-in-class online case management course. While it’s true that many case managers are also nurses, not every element of nurses’ extensive skill set translates into the necessities that case managers must meet. This actually occurred throughout the height of the pandemic.

Nursing and case management

According to Mullahy, many case managers who’re latest to the role should not necessarily aware of the stark differences between the responsibilities and challenges involved, and the way they differ from on a regular basis nursing work. “Some of the skills you need as a case manager transfer from nursing, but many don’t. Many nurses do not have to deal with the complex care planning associated with case management. Nurses are at the bedside and see with the patient while they are on the ward, and when the patient goes home, that’s it. However, properly conducted treatment should involve continuous involvement in the patient’s care as he or she moves around the hospital and beyond. COVID-19 has expanded the need for this type of ongoing attachment to the patient. To fill the gap, more case managers were called in. Demand for skilled case managers he shot up at the height of the pandemic. A larger number of sick patients with different needs were discharged to different facilities. It was up to case managers to organize and coordinate these moves, all while keeping patients and their families (not to mention insurance companies) informed every step of the way. “Many case managers had never done this before – they were mostly used to moving patients home,” Mullahy admitted. “But right now, for example, there were a lot of ventilator-dependent patients who had to be placed in facilities that managers didn’t know, and in many cases, didn’t even know where those facilities were.” This illustrates the kinds of obstacles case managers face, even in the most effective of circumstances. Burnout and frequent uncertainty about patient status contribute significantly to case manager exhaustion, an issue that has clearly been exacerbated by the pandemic.

Unique stressors

Mullahy admits that turnover amongst case managers has been an issue for a while, actually not helped by the myriad stressors brought on by the pandemic. “Before the pandemic, many case managers had unmanageable caseloads and were carrying a tremendous amount of guilt,” she explained. “They work 12-hour days and then go home worrying whether the home health agency showed up at the scheduled time and whether the infusion antibiotics arrived. They make sure patients follow treatment plans, communicate with patients and their families, and keeping other members of the patient’s medical team informed requires a lot of focus, organizational skills and detailed reporting, which can be extremely difficult at times.” Certainly, all nurses are relentlessly committed to the well-being of their patients. However, nurses work in teams where every person is committed to working together to realize the most effective outcomes for those of their care. Mullahy’s circumstances illustrate the style of ongoing obligation case managers feel without the support of team members to assist them with each patient they manage. “Nurses working on the ward know that when they leave, someone will be right behind them to take care of the patient,” explains Mullahy. “Case managers, on the other hand, when they discharge a patient from the hospital, they have sole responsibility for the patient and wonder what’s going on. «How is the family doing? Does anyone make sure the patient takes his medications? bow?’ It’s a completely different, emotionally demanding role.” Appropriate training is essential to help nurses interested in moving into nursing case management and prepare them to handle the unique stresses and nuances of this role.

Nurse case management training

The Labor Office lists case management as one of them the fastest growing professions in the US even before the pandemic. With this upward trend, the need for training has increased along with the role itself. In addition to solid education and clinical experience, effective training is key to learning the details of things not typically associated with standard nursing responsibilities, such as community resources, payment systems, and how best to help patients across the spectrum of care. Mullahy notes that while case management has had to adapt to meet the demands of the pandemic, the core elements of the role have remained largely unfettered, and the training he represents is specifically designed to teach these skills. “The essential elements of case management haven’t really changed in all the years we’ve been doing it,” he admits. “There are certainly small tweaks and new developments being made here and there related to the health care system, such as the use of new technologies, contributing to the collection of population health management data, as well as demographic changes and the increasing incidence of certain conditions. But things like how you evaluate planning and coordination, how you evaluate a plan and then demonstrate and measure results – these things have never changed, and the right training will give you the knowledge and skills you need to do these tasks well, feel feel comfortable interviewing and land a case management job.”

Take these courses to learn more about case management:

Case managers face difficult ethical decisions on daily basis. Whether it’s finding a technique to provide a patient with an expensive, life-saving drug, requiring people to wear a mask to stop the spread of a deadly virus, or managing an above-average caseload, ethics is on the core of our practice. Biomedical ethics exists to guide decision-making in these difficult experiences (Markkula Center for Applied Ethics, 2021).

Team-based health care is provided by two or more people from different professions who share the goal of improving patient well-being. Outcomes similar to pain relief, improved access to health care services, early recognition of treatment failures, or other scenarios could be improved through collaboration between professionals. The delivery of effective team-based and patient-centered care ought to be tailored to the population served and their needs. This module outlines the weather of team-based care and examples of team-based care in various settings.

The courses included on this certification review package cover topics similar to quality management and performance evaluation. Click Show more to view the complete list of courses.