CMSA Today - Issue 1, 2016 - (Page 6)

President's Letter Let's Bring in the New Year with Case Management Best Practices BY KATHLEEN FRASER, RN-BC, MSN, MHA, CCM, CRRN cross all health and human services, case management remains a loosely defined service without title protection. Case managers are routinely confronted by gray areas, which occur when there are multiple stakeholders demanding critical thinking. Regardless of title or profession of origin, practitioners must appreciate that dealing with ethical dilemmas involves the possibility that there may not be a clear right and wrong when a conflict occurs. If we want to preserve the ethical ethos of case management, we as case managers must know the best practices to which we are held and comply with them. Valuable resources such as CMSA's Standards of Practice for Case Management and awareness of the five basic ethical principles should be viewed as practice guidelines and provide the foundation by which to practice. Case managers improve the quality of care in the emerging models for transitions of care in practice settings, highlighting the importance of our communication among all providers and practitioners. Through our focus on empowering the patient on a case-by-case basis, problem-solving by exploring options of care when available and alternative plans when necessary, we achieve the best-practice outcomes. As case managers we always advocate, not only for the client/patient, but also for the providers, the payer, and in some instances the employers, to facilitate positive outcomes for the client/patient, the health care team, and the payer. However, as our CMSA Standards of Practice state, if a conflict arises the needs of the client/patient must be the priority. A case manager's primary obligation is to his or her clients/patients. John Wayne stated, "Courage is being scared to death and saddling up anyway!" That is case management in my viewpoint. Our programs target high-risk patients: those at a high risk of suffering costly hospitalizations and adverse 6 CMSA TODAY "We see our mission as one of providing services to patients in the present to prevent adverse health outcomes and hospitalizations in the future." health outcomes because of complex social and medical vulnerabilities. Case managers work within their best practice and with other disciplines, as well as encourage a proactive outlook, to view care coordination as a preventive activity. We see our mission as one of providing services to patients in the present to prevent adverse health outcomes and hospitalizations in the future. Thus, arranging for supportive services in the home and teaching patients to monitor and take care of themselves are examples of efforts to keep problems from developing in the first place. Since many of the problems are social or functional in nature, community resources and social support services (such as respite care, home-delivered meals, and transportation) often play an important role in planning care. Family and caregivers also play an important role in designing plans of care for people with functional or social deficits. Given the diversity and individuality of each patient's set of problems, case managers' discretion and judgment play a vitally important role in keeping all wheels turning. Our CMSA Standards of Practice are recognized as a tool that case management utilizes within every case management practice arena. They are seen as a guide to move case management practice to excellence. The Issue 1 * 2016 * DIGITAL Standards explore the planning, monitoring, evaluating, and outcomes phases, followed by performance standards for the practicing case manager. They have been adopted nationwide as the best practice for case management, no matter the setting. According to Webster's Dictionary, best practice is defined as a procedure that has been shown by research and experience to produce optimal results and that is established or proposed as a standard suitable for widespread adoption. Wikipedia defines best practice as a method or technique that has consistently shown results superior to those achieved with other means, and that is used as a benchmark. In addition, a "best" practice can evolve to become better as improvements are discovered. On that note, look for our revised Best Practice Standards in 2016. We have begun the process of this revision addressing the new challenges we face in this ever-evolving yet always exciting world of health care. Happy 2016! 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 over 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

Table of Contents for the Digital Edition of CMSA Today - Issue 1, 2016

Community Collaboration
Discharge Planning Regulations
Patient Adherence

CMSA Today - Issue 1, 2016