Winning One for the Team

This time of year everyone is talking about football, and around here, our Arkansas Razorbacks. My thoughts of football tend to revolve around the latest talk of permanent brain damage resulting from the game...but I digress; The topic of this blog is really about having a game plan. In Case Management, we work as a team with the injured worker, carrier, employer, and physician to get the injured worker rehabilitated and back to work. That's the ultimate goal. Sometimes it's an easy win, and other times it feels like reaching Super Bowl level. Let me walk you through some of the play books we have going on.

One of our senior CM team is currently working a catastrophic injury and I saw in an email today she has set forth her CM plan to the carrier for requesting a hand surgeon specialist. The injured worker is likely still weeks away from restoring function to his hands, but early consultation and planning are essential to keeping the recovery process moving forward with the best outcome.

Another RN on our CM team is working a lumbar spine injury that has not RTW since his injury. The injured worker just had a follow up MD evaluation this week, and the physician indicated MMI and RTW are projected in 1-2 months, but he would order a FCE to determine RTW parameters. Planning ahead, she isn't going to wait until the next month before scheduling the FCE. She has already scheduled the FCE to be done the next day after the MD visit. If MMI and FCE order are not achieved at that visit, the FCE can easily be cancelled, but she has planned ahead to avoid delay, and get the earliest RTW release.

And yet another RN CM has a shoulder injury patient that underwent surgery last Tuesday. Planning ahead, our CM obtained a work status prior to surgery for an appropriate LD RTW on the day following surgery. If something happens in the operative course where that is not appropriate, restrictions can be revised. But she didn't wait until the ten day post op visit to obtain a LD RTW, saving a week of TTD.

I could continue to name examples for all our nurses, because for all our cases we always have a case management plan, and a back up plan. Kind of like the receiver getting the football from the quarterback (physician) and running with it. Is your team color JMS Blue?

Comments

At the Heart of Case Management

I have done presentations on The Benefits of Case Management to carriers, peers, and other health care professionals. Sometimes it sounds dry and philosophical to list benefits: access to care, best practice recovery, lowered cost expenditures. But who is the one that benefits? In our practice, is it the injured worker? the employer? the insurance carrier? From the Case Management Society of America, "It is the philosophy of case management that when health care is appropriately and efficiently provided, all parties benefit." Allow me to demonstrate for you the heart of case management from two of our case managers this week. One of our CM Team has a patient that was "swimming" amidst a work injury and numerous mis-diagnoses and was fearful this CM's job was to just "write him off." Our RN worked to find a physician that would clarify his diagnoses, even collaborating between his group health carrier and Work Comp carrier. At the conclusion of a...

The Head Bone's Connected to the Neck Bone...

My first test in college anatomy we were given a piece of paper with numbered lines, 1-206. Instructions were simple: Name the 206 bones in the body. I made 100% - thank you. Learning anatomy of all the body systems, and the physiology of how they interact is my love in the medical field. The science of it all fascinates me. There is a logical physiologic reaction to bodily injury, and a RN Case Manager's critical thinking skills help anticipate symptoms and complaints. If you hit your thumb hard with a hammer, we know you will have pain, and probably stiffness; and if you smashed it good enough, you could have "sympathetic" stiffness of adjoining fingers in the hand. That is a known physiologic response. Stacy Mathis, RN has a patient with multiple injuries has begun to relate all aches and pains to his MVA. The problem is, not all his complaints can be physiologically connected to the injury. This is quite common in catastrop...

Case Management GPS

W The next time I purchase a new vehicle there are several features I have on my wish list. For as much as we case managers travel, Navigation is high on the priority scale to make life easier. Under the pressure of arriving at a physician appointment on time, it's never a good feeling to take a wrong turn or get lost. There are times our role as a case manager is much like a navigator. Deana Scott, RN had that experience just yesterday while attending a physician visit. After three years of treatment for a work injury, the physician had nothing further to offer, and there appeared to be issues of malingering and symptom magnification. There was a point at which the physician actually had a look in his eye of being lost as far as how to bring the treatment course to an end. Confusion centered around the injured worker's return to work goals. It's at times like this, a Case Manager is able to maintain focus and much like a navigato...

Cheryl's Blogspot

Search This Blog