Case Management

Mentor moment: Do case managers communicate effectively?

Case Management Weekly, April 28, 2010

The following article is adapted from HCPro’s resource for hospital case managers——a free blog dedicated to connecting hospital case managers to industry pacesetters, peers, and best practices.

The case manager’s main goal is coordinating care and collaborating with other members of the healthcare team. It is doing what is right for the patient, in the right setting, and in the most cost efficient manner. These goals require that case managers communicate effectively with patients and the appropriate healthcare providers.

Case managers spend time getting to know patients personally and through their medical records. This holistic approach gives them a full picture of the patient.

Admission case managers at Jennie Edmundson Hospital collect patient history, identify fall risks, and conduct medication reconciliation. They also conduct the initial case management environmental assessment.

Case managers and social workers discuss patients’ current condition and plan for discharge during daily morning huddles. Social workers and case managers then proactively discuss patients’ discharge plans with their physicians. This meeting affirms that everyone, including patients and their families, understands what is happening. We also conduct interdisciplinary rounds, during which social workers and case managers discuss patients with a larger group, including:

  • Physician advisors 
  • Unit nurses 
  • Physical and respiratory therapy staff members 
  • Dieticians 
  • Diabetic educators 
  • Wound care nurses 
  • Pharmacists

Bedside nurses and case managers sometimes overlook the importance of daily communication with each other. Encourage bedside nurses to seek out their units’ case manager(s) daily to discuss changes in patients’ conditions and discharge plans. Bedside nurse sometimes may be missing crucial information that a case manager and/or social worker may have obtained from the patient’s physician.

As case managers and social workers communicate with patients and/or their families with respect to discharge planning, we must ensure that bedside nurses are also key participants. Bedside nurses provide education and discharge instructions to patients, so they must have all necessary information.

My facility encourages this type of communication. Do your case managers and/or social workers communicate with physicians and bedside nurses on a regular basis?

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