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Answering your questions about case management models

Case Management Weekly, December 4, 2007

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The Center for Case Management's Karen Zander, RN, MS, CMAC, FAAN, and Shawna Kates LSW, MSW, MBA, CMAC, answer your questions about the ideal caseload, the roles of physician advisors and clinical nurse leaders, and connecting the bedside and the boardroom below. Zander and Kates answered live questions as part of the Case Management Monthly audioconference "Transforming Case Management Models: How to connect the boardroom to the bedside." To listen to a full-length replay of the audioconference, or to order a CD copy, visit www.hcmarketplace.com/prod-5713.html.

What are the benefits of having a physician advisor (PA), and can this be a part-time role?

Karen Zander (KZ): Depending on the complexity of the organization, it can be a part-time role, given other aspects of that person's practice. A PA definitely has to be respected by other physicians, and if they do have a practice besides PA, they shouldn't be at the mercy of referrals from other physicians to them. But whether they're part-time for eight hours or half-time or whatever, I think the role has to be really well defined (see below for a guide for defining the role of the PA) so we need to say things like "We want you to spend two hours doing this and one hour a week doing complex care rounds," so it's not the amount of time but how the time is organized.

Shawna Kates (SK): I would also suggest it's the "when." For example, if you are having a part-time PA, and that person is working Monday, Wednesday, and Friday, there's got to be some measure of cover on Tuesday, so there's someone cushioning the process for the PA's return on Wednesday. There's got to be some fluidity in the process.

KZ: Some of that may mean that the PA is part of committees in their other life, so they start to really change a culture, not just confront doctors about a particular practice.

Source: You can read the entire Q&A about case management models in the December issue of Case Management Monthly.

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