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CMW Tip of the Week: Case load confusion

Case Management Weekly, June 11, 2008

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This week’s tip, an ask the expert, is provided by June Stark, RN, BSN, MEd

Question: Case managers often feel overwhelmed by their case loads. What are some tips to balance front and back burner cases?

Answer: The first step to balancing case loads is distinguishing between short-stay and long-stay cases. Focusing on either one too much will result in missed opportunities for LOS reduction, quality of care, and utilization.

Try the following approaches:

• Spend a good part of the day on the short-stay cases, but make sure to move your attention each day to the long stays. These complex patients require daily review, with planning and intervention as necessary. When this does not occur, case managers are “riding the case.” They let the case pull them, sometimes in a direction of prolonged stay, rather than having them “drive” the case in a direction of efficient discharge.


• Manage shorter LOS patients in the morning. Do this for all cases and for the entire healthcare team. Account for each moment of the stay with diagnostic, procedural, and/or treatment interventions. Anticipate delays and, when possible, set up interventions before they happen. Hold regular family meetings to move the family along at the same pace as the caregivers or to seek guardianship in the absence of a significant other.

Have a question that you’d like to ask our experts? Email it to jmcginley@hcpro.com. Your question could be featured in the next issue of Case Management Weekly!

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