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Q & A: Evolution of case management

Kathleen “Kathy” Fraser, MSN, RN-BC, MHA, CCM, CRRN, serves as president of the Case Management Society of America, an organization she joined more than 23 years ago. As president, she looks forward to helping case management professionals meet the challenges of an ever-changing healthcare system. A nurse for 33 years, Fraser serves as the regional team manager of managed care case management for Zurich. Financial Services.

Fraser recently spoke with about her goals for CMSA, the role of nurse case managers and their top challenges.

Q: How would you explain what nurse case managers do to a new neighbor?

A: We advocate for patients’ well-being and improve healthcare outcomes through the healthcare continuum. We assist patients to navigate through what can feel like a maze. Furthermore and most importantly, we empower those patients and caregivers with knowledge for them to make the decisions that are right for them.

Q: What are the top challenges for case managers?

A: Providing evidence-based tools and resources to all stakeholders. This is one of the many areas CMSA serves our membership, by offering these tools and resources. Case managers are usually too busy doing their daily jobs. They do not have time for research and development. We have those evidence-based tools to assist in making case managers jobs a little easier.

Q: When is nurse case management a more efficient and cost-effective way to follow patients? What are some of the factors?

A: When you have patients or populations, which are either high risk, complex or catastrophic. The complexity or risk may be due to diagnosis or psychosocially coinciding with added barriers of low health literacy and probability of medication adherence to lack of a support system. Case managers appreciate and collaborate with the entire interdisciplinary team. The team approach is recognized as a stronger emerging model especially for the medically complex patients.

Q: In looking at the evolution of the standards of practice for RN case managers, what changes do you believe have made the most difference?

A: The standards illustrate why we are the recognized experts and vital participants in the care coordination team. The standards stress we empower people to understand and access quality, efficient healthcare. It recognizes our worth as financial stewards and our ability to work with all stakeholders yet stresses in times of ethical conflict, patient advocacy always comes first. They lay out the ethical standards of care we practice and serve to support the case management profession. Most case management companies and/or departments use or address our standards as their basis for policy.

Q:Can you please talk about the employment outlook for nurse case managers?

A: One word, fabulous. We are the [key to] true healthcare reform and the word is getting out. It is the place to be and will continue to be.

Q: As president, what are your top goals for the organization?

A: Continuing to foster case management growth and development by supporting our chapters across the country and our community of case management worldwide. Through this support, grow our membership. As Helen Keller said, ‘Alone we can do so little, together we can do so much.’ CMSA is the leading membership association for case management providing professional collaboration. Also, expanding the educational process of what case management is and the extraordinary benefits we bring not only to patients but also to lowering healthcare costs. We are the key to productive and real healthcare reform. We can and have started impacting healthcare policy and I want to continue that initiative.

Q: What do you enjoy most about being a certified case manager?

A: Professional certifications from accredited, respected organizations, which are nationally recognized, prove that he or she has the knowledge, experience and skills to perform a specialty. They are a valuable component for a case manager. In many settings, certification is required, and I predict that in the future, it will be mandated as part of our specialty. I am certified with the Commission for Case Manager Certification, the American Nurses Credentialing Commission for Case Management and as a certified rehabilitation registered nurse through ARN. I am very proud to hold all three.

Q: What attributes, skills and educational preparation are essential to becoming a case manager?

A: A degree as either a registered nurse, social work or a related healthcare field and their applicable licensing. In my opinion attributes are being flexible, the ability to think outside of the box, a proactive can-do attitude, strong communication skills and the presence of an ability to use critical thinking during all aspects of care.

Q: When did you know you wanted to become a nurse?

A: I knew I wanted to be a nurse when I was a junior in high school and came upon a car accident on my street immediately after it occurred. The girl was a freshman and a neighbor. She had been thrown through the windshield with facial lacerations and refused help because she was intoxicated. I calmed her down, assisted with the bleeding and convinced her to let me call an ambulance. From then on I knew that was my calling. I know it sounds hokey but it is really a passion. I love being a nurse. I think of it truly as a calling, not just a profession.

By | 2014-11-21T00:00:00-05:00 November 21st, 2014|Categories: National|0 Comments

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