Case Managers Provide Advocacy for Their Patients & Families

A patient is seen by her physician every month; she complains of weight loss and confusion. She is given referrals to specialists and told to follow up. Month after month; the same story. The referrals sit in her purse because she can’t figure out how to navigate the phone tree at the specialists’ offices. The weight loss and confusion continue, month after month. She’s lost over 50 pounds in 5 months and she now cannot figure out how to work her cell phone, much less make the appointments. She’s embarrassed to tell anyone that she can’t do these “simple” things, so they go undone and her health continues to decline.

What this patient needs is a case manager and the broad network of support the CM RN/SW can access to help this patient navigate through all the phone calls, appointments and paperwork. The case manager meets with the patient and her family, assesses the situation and creates a plan to most effectively support this patient’s needs. In this case, the physician agrees that home health services are in order; home health RN, ST, OT, PT and MSW are activated and community services are accessed for meals and transportation, pending more definitive diagnostics. The case manager coordinates care by working with the primary care and specialists’ offices; communicating the situation and schedules the necessary appointments for the patient with their in
put. All the while, the case manager keeps the lines of communication fl owing between patient and all care providers.

As illustrated by this scenario, the Case Manager RN/SW is the key to reducing the fragmentation of healthcare. Case Managers are an integral, but underused part of the healthcare team. This is simply because the awareness of their existence is not in the mainstream.

For Our Patients and Their Families: Anyone who has any form of health insurance can access a case manager by calling the number on the back of their insurance card and asking to be connected to a Case Manager. Case managers are embedded in hospitals, clinics, community service agencies. Every person deserves a case manager as their corner; they advocate, coordinate and collaborate for the good of their patient and their family. If you need help to find a Case Manager, please feel free to contact us at info@cmsa-chicago.org. We will be happy to connect you with resources to find a Case Manager.

For the Healthcare Team: Just as Case Managers provide guidance and support for their patients/clients, one organization is providing more support, resources, forums, and outlets for the case management community more than any other, Case Management Society of America/CMSA. CMSA Chicago is the local professional organization, providing education, networking and support to the entire Case Management community from the CM RN and SW to the service providers supporting our patients in their individual situation and beyond, CMSA Chicago brings everyone together to make navigation of healthcare easier for the most important member of the healthcare team; the patient/family!

CMSA Chicago is here to support the entire case manager community from Case Manager RN/SW in every setting, across the continuum of care to the myriad of service providers who offer a full spectrum of support to our mutual patients. We encourage you to attend an upcoming event and connect with your professional organization. More information is available at

www.cmsa-chicago.org.

Editor’s Note: This article was submitted by Colleen Morley DNP RN, CMCN, ACM. Colleen is President Elect of CMSA Chicago. She can be reached at colleen.morley@cmsa-chicago.org.