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Regardless of the healthcare setting in which they work, case managers are likely to encounter challenging patients and family members those who are irate, provocative, depressed, or just plain ornery.
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Patient flow and boarding have been recognized for some time as problems that hospitals need to address. But whatever is being done isnt enough, and The Joint Commission (TJC) released a report in December outlining new standards in the Leadership section, some of which came into effect on January 1, and some of which will take effect in another year.
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To eliminate gaps in care after their members have been hospitalized, Cigna Medical Group has assigned RN care coordinators to local hospitals to act as a bridge between the primary care practice and the hospital and has a dedicated team of physicians, pharmacists, and nurses who see the majority of patients for their first follow-up visit.
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Every healthcare professional needs to develop a basic set of skills to help them cope with difficult patients so they can get through the encounter and not come out emotionally bruised, says John Banja, PhD, professor of rehabilitation medicine, medical ethicist at Emory Universitys Center for Ethics and director of the Section on Ethics in Research at Emorys Atlanta Clinical and Translational Science Institute.
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While new requirements are not always welcomed in the ED, to be sure, managers and front-line providers do have reason to feel optimistic about new standards, unveiled by The Joint Commission (TJC), regarding how hospitals manage patient flow.
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The emergency medicine community has pushed hard against complaints that too many patients with non-urgent needs are being seen in the ED, but there is little doubt that so-called super-utilizers patients who come to the ED regularly for one reason or another are not receiving the kind of care they need in the most appropriate setting.
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As documented in the CDCs National Hospital Ambulatory Medical Care Survey (NHAMCS), the population of patients being seen in American EDs continues to get older, except in EDs with a mission to serve children.
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Molina Healthcare offers Native Americans covered by its Medicaid managed care plan a Traditional Medicine Benefit, which gives them a stipend to spend on traditional healing.
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Recognizing that case management programs should be tailored to the special populations being served, health plans are creating specialty programs to meet the needs of their members.
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Pediatric case managers from UPMC for You collaborate with caseworkers to ensure that children in foster care get the care, preventive, and behavioral health services they need.
