Working Across the Continuum of Care
We recently spoke with Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC, CCM, president of The Case Management Society of America (CMSA) to learn more about the critical role that case management nurses play in patients’ lives.
I later became the director of case management for another acute rehabilitation hospital and my case management education accelerated. I became a certified case manager, completed a master’s degree in nursing, was certified as a clinical nurse specialist and an advanced practice nurse, and later earned a doctorate degree in nursing. Currently, I am a senior director for care management for three Cleveland Clinic Hospitals and serve as the national president of the CMSA.
Although it is not exclusively a nursing role, most case managers are nurses. Case managers help patients understand their diagnosis, options for treatment, and the complex healthcare system. Case managers work in settings across the continuum of care. A case manager may work for a large or small health insurance provider, in workers' compensation insurance with a selected population of patients, or in acute care hospitals, providing support and guidance to patients in the care coordination process. They may work with patients who are designated as high risk, or patients with chronic diseases, such as heart failure or Chronic Obstructive Pulmonary Disease (COPD).
Today more than ever, with the change from a fee-for-service to a value-based medical model, and the shift to population health — an approach that aims to improve the health of an entire population — case managers can be the key to success. The unique services a case manager provides are essential to helping patients manage their own health.
Population health models will create extended teams of case managers and non-licensed case manager extenders who will manage large groups of patients. A case manager may be responsible for overseeing patients in different states with his or her team of experts. Telehealth will also play a role in this change, as it will allow the case manager to care for many more patients.
CMSA is the leading membership association providing professional collaboration across the healthcare continuum. The organization aims to advocate for patients’ wellbeing and improved health outcomes by fostering case management growth and development, impacting healthcare policy, and providing evidence-based tools and resources.
I would tell any nursing student seeking to specialize in a particular field to spend at least one year in medical-surgical nursing. It is challenging work, but it is satisfying and rewarding. In my opinion, medical-surgical nursing is the foundation for nursing practice. Additional fields in nursing that will provide good preparation for case management are home care, hospice, public health, acute rehabilitation nursing, and emergency department nursing.
Case management is a challenging and rewarding field. The nurse case manager has to think outside of the box and explore every possible method to help his or her patients.
Visit www.cmsa.org for more information about The Case Management Society of America.