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It is challenging for case managers and healthcare providers to discuss end-of-life issues with patients, particularly when they are facing a life-threatening injury or illness. But it is useful to make advance directives a part of a palliative care service as well as a general part of case management with geriatric patients after a traumatic injury.
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With the goal of continuous quality improvement, a health system created programs and tools to provide care for older patients that focuses on advance care planning, cognitive decline, and how to ensure safe transitions. The goal is interprofessional geriatric care and providing good care to complex, hospitalized older adult patients.
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Millions of older Americans visit emergency departments each year, often for traumatic injuries, including falls that can lead to death. Case managers and health systems should consider how to improve end-of-life care discussions and advance directive documentation in this population.
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When denials occur, case managers should create a plan to investigate and manage each one to determine why the claim was denied and how they can help. Using this approach, some managers have uncovered trends and root causes that can prevent future denials. It is critical for case managers to hone this skill for the benefit of the patient and the hospital.
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In a perfect world, an ill patient would recover in the hospital and return home as soon as possible. When they are medically stable and can leave the inpatient care setting, nothing is holding them back. Unfortunately, that does not always happen. Even when patients are medically ready to return home, they end up waiting in the hospital longer. A prolonged hospital stay typically is described as a stay that persists for a certain number of days (often 10 days) past the patient’s geometric length of stay. The problem of prolonged hospital stays seems to be getting worse.
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High-risk patients with inflammatory bowel disease experience high direct costs and a substantial symptom burden. Researchers designed a care coordination-based solution to improve their symptoms and reduce care costs. The solution was cost-neutral, but helped improve patient symptom scores.
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The quadruple aim healthcare model continues to evolve as healthcare providers realize the importance of social determinants of health. Healthcare professionals need to develop a trusting relationship with patients, which is part of the quadruple aim’s goal of enhancing patient experience.
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The results of a recent study revealed a care transitions clinic can reduce emergency department discharge time and increase the clinic’s rate of successful transition to community primary care. Intervening within 72 hours of discharge is important for patient engagement and facilitating education about their health and care management.
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Case managers are combatting stress, compassion fatigue, and burnout on several fronts as the COVID-19 pandemic surges across many parts of the United States. They are fighting to help patients and families at a time when hospital resources are strained and care transitions are challenging. They are fighting their own grief as more patients die. They are combatting misinformation online and in person as anti-vaccine and anti-mask patients make their views loud and clear.
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Case managers and other providers see patients who are frustrated by long waits and the numerous, sometimes-changing infection prevention rules. The anger comes from more than just the patients who are sick with COVID-19. The pandemic has affected case management for all patients, not just those with COVID-19.
