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1. Become more data-savvy.
Learn to manipulate the data you have to identify patients who are likely to need complex care, suggests Liza Greenberg, RN, MPH, vice president of research and quality of URAC.
2. Familiarize yourself with the clinical literature for evidence-based practice.
"Companies are really trying to develop care management protocols along evidence-based guidelines," Greenberg says. For instance, know that asthmatics are supposed to have this kind of treatment or that people with congestive heart failure need to follow a certain protocol. "If they know this, case managers will be an asset to the companies they work for," she says.
3. Continue to push for standards and regulations to give case management’s role in health care the recognition it deserves.
"Case managers have an opportunity to expand their role in health care, but they have to gain credibility in order to do so," asserts Brian D. Klepper, PhD, president of Healthcare Performance Inc., a Jacksonville, FL-based health care business development practice and executive director of the Center for Practical Health Reform. "If they don’t have the power within their individually organizations to do it, they should continue to strengthen their ranks through professional organizations," Klepper adds.
4. Be prepared to show that your interventions work in order to have credibility within your organization.
Case managers should track quality of care indicators and show how their interventions work and the cost savings they generate. For instance, be able to show that not only did a higher percentage of congestive heart failure patients get discharged at 100% adherence because of your intervention, but be prepared to show how much money it saved your organization. This undoubtedly means that you will have to eliminate your paper records and switch to a computerized system to manager your patients, Kibbe says. "You cannot do that on paper unless you have many more staff. And if you think any case management department is going to get more staff, you are mistaken," he says.
5. Take a role in clinical practice guidelines being developed by your organization. Familiarize yourself with specialty society web sites, as well as the National Institute of Health, and Agency for Health Care Research and Quality web sites, which have national guidelines, Greenberg suggests.
6. Educate yourself on health care sites throughout the continuum where you patients may seek treatment.
For instance, there probably are a variety of settings for rehabilitation. Educate yourself so you can help patients choose the best ones for their particular needs and help them make sense of the outcome-based information that may be on the facilities’ web sites, suggests David B. Nash, MD, MBA, the Dr. Raymond C. and Doris N. Grandon Professor of Health Policy and Medicine and Director of Health Policy and Clinical Outcomes at Thomas Jefferson University in Philadelphia. Start with those in your geographic area and expand your knowledge base to include regional and national center of excellence.
7. Prepare for the next generation of patients by becoming Internet savvy.
There’s no way around it. Your patients, your employer, and the people with whom you communicate are going to mandate the use of the Internet for communication, business, and referral purposes. Kibbe cites statistics that show that two-thirds of all households have computers. Many people use web browsers and communicate by e-mail daily, he says. "Patients are increasingly demanding to know what their options are. The Internet is another technique that case managers can take advantage of," he says.