CMSA Today - Issue 6, 2015 - (Page 7)

President's Letter Unique Care Situations and Solutions BY KATHLEEN FRASER, RN-BC, MSN, MHA, CCM, CRRN T his issue of CMSA Today is dedicated to unique care situations and solutions. We strive to bring you a balanced view of controversial or hot topics surrounding care delivery. Case managers need to be a critical component of these systems throughout the continuum. We provide expertise and clarity to complex medical issues, including identifying obstacles to delivery of quality, facilitating prompt quality health care treatment, and coordinating resources. Understanding the pros and cons of a topic are essential before one can intelligently debate or analyze the topic. The conversation surrounding pain management through the use of medical marijuana versus conventional pharmaceuticals is one area of care delivery for case managers to consider and understand. Proponents of medical marijuana argue that it can be a safe and effective treatment for the symptoms of cancer, AIDS, multiple sclerosis, pain, glaucoma, epilepsy, and other conditions. They cite dozens of peer-reviewed studies, prominent medical organizations, major government reports, and the use of marijuana as medicine throughout world history. Opponents of medical marijuana argue that it is too dangerous to use, lacks FDAapproval, and that various legal drugs make marijuana use unnecessary. They say marijuana is addictive, leads to harder drug use, interferes with fertility, impairs driving ability, and injures the lungs, immune system, and brain. They say that medical marijuana is a front for drug legalization and recreational use. The struggling economy and controversial health care reform laws are key issues that affect Americans on a daily basis. These facts, combined with trends and new care delivery options such as medical marijuana, will continue to evolve the health care industry and case management as well. Case management serves as a means for achieving client wellness and autonomy through advocacy, communication, education, identification of service resources, and service facilitation. The case manager helps identify appropriate providers and facilities throughout the continuum of services, while utilizing available resources timely and costeffectively to obtain optimum value for both the patient and the reimbursement source. We are professionals who provide strategies to address challenges and ensure that care is patient-centered, safe, and effective. The key is in the coordination of care, with identified timeframes for accomplishing appropriate care outcomes. Case management also provides a well-coordinated care experience to improve the care outcome, decrease the length of stay, and use multiple disciplines and services efficiently. There is a myth and faulty belief among case managers and other experts that the standard of care is static, fixed, and permanent. The standard of care is a very important legal construct as it is the standard against which we are judged in malpractice suits and licensing board hearings. Most broadly, the standard of care is defined as the usual and customary professional standard practice in the community. It describes the qualities and conditions that prevail, or should prevail, in a particular mental health service, and that a reasonable, average, and prudent practitioner follows. Generally, as more therapists practice in a new and unique way, this new way gradually becomes part of the standard of care. The standard of care is derived from statutes, case law, licensing board regulations, consensus of the professionals and community, and ethics codes. The standard of care is not a standard of perfection, black and white, determined by outcome, permanent, or fixed. It does not follow any particular theoretical orientation, nor is it guided by risk management principles. Continue reading and discover unique ways in which your fellow case managers are creating work solutions. Kathleen Fraser, RN-BC, MSN, MHA, CCM, CRRN President, CMSA National Board of Directors 2014-2016 Kathleen Fraser is the president of CMSA National, and a past president of Houston/Gulf Coast CMSA Chapter. She has more than 35 years of nursing experience, and more than 21 years of case management experience with 20 years in workers' compensation. Fraser has worked in acute hospital, long-term care, and insurance managed care. She can be reached at Issue 6 * 2015 CMSA TODAY 7

Table of Contents for the Digital Edition of CMSA Today - Issue 6, 2015

Post-Traumatic Growth: The Journey
Optimal Healing Environments in Home Hospice and Palliative Care
Successful Patient Engagement in an Employer-Based Wellness Program

CMSA Today - Issue 6, 2015