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It is entirely understandable for emergency providers to question any new task or responsibility handed down by regulators or administrators. Busy providers are already stressed with burgeoning patient volumes and all the pressures associated with handling acute care crises.
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As a case manager, your job isnt done just because you told a patient something. Your job is done when the other person understands it, says Helen Osborne, MEd, OTR/L, president of Health Literacy Consulting, a Natick, MA-based firm.
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Sometimes just making people aware of their performance is all that is necessary to significantly improve care. Investigators at the University of California at San Francisco (UCSF) found this to be precisely the case when they attempted to use this approach to improve door-to-needle times for stroke patients who presented to the ED for care at UCSF Medical Center.
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As part of its efforts to reduce admissions and emergency department visits, Capital District Physician Health Plan (CDPHP) has embedded case managers in 15 primary care practices and is conducting a pilot project that embeds a case manager in a local hospital.
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Whenever theres something new that has to be done, theres a tendency for administrators in many settings to assign the task to case management, often with the comment that theyre already in the patient record.
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Group Health Cooperative's case managers target patients with complex medical conditions and/or psychosocial issues who have been hospitalized and work with them on managing their health with a goal of avoiding admissions, readmissions, and emergency department visits.
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As health care reform continues to unfold and performance-based payment models make more headway, emergency providers are pushing the boundaries beyond what the market has traditionally expected from this field of expertise.
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The debate raging over whether it is wrong or right for lawmakers to be looking at ways to limit ED utilization may be missing the more important discussion.
