Making it Personal

When we are taking care of treatment arrangements and details, calling clients for updates and problem solving, attending physician visits with clients - sometimes with lengthy wait times, we establish a professional relationship with them. From the client's perspective it can seem even "personal", although it's overwhelmingly a 1-sided sharing of information. This is true not only in case management, but in every field of nursing, because nurses show empathy and compassion for others as we provide "care" for them.

I caution adjusters and carriers not to think of case manager tasks as clerical, or messengers, or that our clinic wait time is a "waste" of time. All our communications with clients are taking care of their needs - "medically" physical and emotional. The results of our nursing can seen not only in the gathering of information, treatment planning, but also in improved patient compliance and understanding, and outcomes. All going toward the goal of healing within optimal time frames. We ARE making it personal - to the patient.

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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...

Slipping Under the Radar

A work injury is NO vacation! Most of us would agree with that statement. It's never fun to get hurt, yet it doesn't stop an injured worker from trying to turn recovery time into paid time off. It is very common to have clients make requests to postpone procedures, therapy and return to work for personal reasons. If this request is made to a physician under their group health insurance, it is not really an issue. However when such a request is made during healing timeframe from a work injury, this is not an appropriate or reasonable request. As Case Managers, we must remind both the injured worker and providers that during recovery and rehabilitation time the injured worker's "job" is to heal and comply with appropriate treatment and work status. Just this week, Deana Scott, RN had a client to request postponing her light duty return to work until she could finish outpatient therapy. What Deana reminded her of, was that the activity of...

Patient Advocacy

Stacy Mathis, RN Because JMS Consulting is the premier provider of case management services in Arkansas, we are approached frequently by out of state companies with a service request to work files under the guise of their namesake. As long as our business philosophy and standards align, we do this for a few companies. We recently parted ways with one such "national" company after they asked us to change wording in our reporting, as "the carrier might think we were advocating for the patient and not the customer" -- REALLY??? Of course, we were! At JMS, we believe in getting our patients the best treatment, with the best providers. Our professional networking and resourcefulness help fill in gaps of care and move things along to reduce the costs of recovery from a work injury. Today I read an article in CMSA Today on " Collaboration in Case Management " that deftly explains the case manager's role in the managed care system; "A case mana...

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