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Complex case

Case Management Weekly, March 17, 2004

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Complex case

A 64-year old female presented to the ED on a Sunday evening with med-sternal chest pain radiating down her right arm and up into her jaw. An EKG revealed changes consistent with an inferior wall myocardial infarction. Two sets of cardiac enzymes were ordered and the patient was admitted to the cardiac telemetry unit. The patient had a number of co-morbidities including diabetes, hypertension, and slight renal involvement. The admission clerk acquired the patient's name, address, and social security number. The patient claimed that she had no insurance, as well as no family or friends. She said she lived alone in her parents' home and both of them were deceased. The home was still in their name and the patient had not taken any steps to convert the deed into her name.

The case manager never had a chance to assess the patient because during the night she had a massive stroke. The patient was comatose, intubated, placed on a ventilator, and moved to the ICU. A neurology consult was called and the prognosis was unclear. The physician ordered an MRI, but the patient was too unstable to move.

How should a case manager handle this type of case? Find out in the April issue of Case Management Training Monthly. Click here (http://www.hcmarketplace.com/Prod.cfm?id=2311) to order your subscription or call customer service at 800/650-6787 and mention source code EB24489E when you call.

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