CMSA Today - Issue 8, 2013 - (Page 6)

CMSA President's Letter It's Time to Lift the Curtain BY NANCY SKINNER, RN-BC, CCM A s a child, I was morbidly obese. Of course, in the 1960s we used the more acceptable term of "chubby," but the fact remained that I was too short and entirely too round. Although I wasn't proficient at playing team sports, I excelled at going to the movies, reading books, and watching television. One of my favorite old TV movies was The Invisible Man. The movie featured 1930s visuals and a rather gruesome storyline of a scientist whose experiments resulted in both madness and invisibility. This was probably not the best tale for a child, but the invisibility of the main character held my interest as someone who felt physically unattractive. As I grew and "old-old" television movies gave away to "newer-old" movies, I fell in love with The Wizard of Oz. While other children loved characters such as Dorothy and Toto, the Scarecrow, the Cowardly Lion, the Tin Man, Glinda the Good Witch of the North, and the Munchkins, my favorite character was the Wizard-the great and powerful Oz! Even after he was exposed as a kind, ordinary man from Omaha, I loved him because he made a difference. He was short and a bit round, but he helped others attain their dreams. As the years have passed, my taste in books and movies has changed, but I will always love the Wizard. Maybe it was that desire to help others that brought me to nursing and, ultimately, to the practice of case management. This issue of CMSA Today is dedicated to the consumer perspective of case management. Throughout the past 15 years, the phrase "Case Management - the bestkept secret in health care" has been used by myself as well as other case managers and care coordinators. However, defining my role to the health care consumer - and even my family - has not always been easy. 6 CMSA TODAY Issue 8 * 2013 Telling patients I am their advocate may imply that my role is tied to funding or social programs. Saying I am a representative of an insurance carrier may foster fears in patients that I am dedicated to saving dollars rather than advancing the quality of care. And, cold calls in response to the identification of a catastrophic illness or injury or a chronic disease state may be received in a less than enthusiastic manner. Unfortunately, I do not believe the health care consumer has a clear perspective of case management. Our role, functions, value, and contributions to health care delivery in America are often hidden behind a curtain of unclear or misleading titles, phone cues and voice mail systems, and policies that prevent the care coordinator from gaining direct and consistent contact with the patient, their family, or support system. In the Wizard of Oz, the Wizard's guard states, "Orders are: Nobody can see the Great Oz! Not nobody, not no how!" Do our patients experience similar barriers when reaching out to us, or is it our greatest barrier that many patients do not know we exist? Are we invisible in the actions we take or in the care we facilitate? Do our patients consistently know our names, what we do and why we are important members of the health care delivery team? Dorothy found a way to meet the Wizard and ultimately achieve her goal of going A case manager is not judged by how many dollars are saved, but by how many lives are touched and how many patient goals are advanced. home, with a simple wish and a click of the heels. Each of our patients has goals whether they are identified and attainable or indeterminate and improbable. For our patients, the journey often includes many more obstacles with an unclear or unreachable destination. While Dorothy had a Wizard, our patients may not have any support system or be aware that a case manager or care coordinator is available to assist them. So, what can we do to become a more visible component of 21st Century health care delivery in America? First, we need to pull back the curtain to reveal our roles as advocates, facilitators, assessors and detectives, educators, planners, communicators, and so often, miracle workers! In late September 2013, the United States Senate took a step in this direction with the passage of Senate Resolution 214. That action recognized the week of Oct. 13-19, 2013, as National Case Management Week, and included the following statement: "Case managers are advocates who help patients understand their current health status and ways to improve their health, and in this way serve as catalysts who guide patients and provide cohesion with other professionals in the health care delivery team." These are some very powerful words that truly do represent the practice of health care case management. The document also states: "Resolved that the Senate also encourages the people of the United States to observe National Case Management Week and learn about the field of case management." We must consider identifying a metric that truly quantifies the value case managers bring to global health care delivery. We can no longer base our efficacy on dollars saved or complications avoided. We must find a method for measuring our

Table of Contents for the Digital Edition of CMSA Today - Issue 8, 2013

Where Was Care Coordination?
Preparing Patients for Their Journey Ahead

CMSA Today - Issue 8, 2013