CMSA Today - Issue 2, 2013 - (Page 22)

For want of a shoe, the horse was lost. For want of a horse, the rider was lost. For want of a rider, the battle was lost. For want of a battle, the kingdom was lost. And all for want of a horseshoe nail. Modifying that rhyme, I might say: For want of a cushion that cost less than $500, at least $500,000 has been spent over the past ﬁve years to ineﬀectively address the events that have brought Frank to where he is today. You might ask, what is next for Frank? Frank thinks, “Medicare would rather have me die than keep me alive.” I believe Frank needs someone to take the time to help him ﬁnd his way through the maze of services that is health care delivery in America today. I believe he needs a case manager who is dedicated to meeting his needs, not just “short shifting” him as he moves from one provider to another. I also believe someone must take the time to ask Frank what he needs, and so I did. You probably will not be surprised by some of his responses as many of his needs are fairly evident. Other needs can only be identiﬁed when you walk beside Frank or follow closely behind him. These are some of Frank’s requests and some of my “asks” for Frank: • Appropriate seating for his wheelchair in order to prevent further deterioration of his minimal gluteal mass. • Access to a physiatrist who could coordinate his physical medicine and rehabilitation needs. • Nutritional support including the availability of products that support collagen formation and tissue building. • Appropriate bracing or other support for his spine below the previous fusion. • Wound care that is focused on prevention of further destruction and resolution of tissue damage if that resolution is possible. • Assistance in obtaining privately and publicly funded support for necessary services, i.e. Medicaid, SNAP, transportation, utility bill assistance. • Support for his wife, who is his primary caregiver and suﬀers from depression. 22 CMSA TODAY Issue 2 • 2013 • Medication therapy management to assure appropriate pharmaceutical intervention. • A comprehensive assessment and subsequent recommendation for durable medical equipment that might facilitate the ability to maintain his independent living status. (Author’s note: At discharge from acute rehab to home, only two of the abovedetailed requests were accomplished – physiatrist follow-up and appropriate spinal bracing. All other “asks” were essentially ignored by the sending facility.) It is my sincere hope that Frank will gain and maintain access to: a case manager who will be focused on advancing his ability to achieve the goals he wishes to achieve; a case manager who accepts the roles and responsibilities of case management as deﬁned by our Standards of Practice; a case manager whose primary goal is eﬀecting an appropriate transition of care for every patient; and a case manager who can focus on Frank’s asks without stating, “I have 25 other patients and I am wasting my time talking about Frank.” I expect case managers to challenge systems on their patient’s behalf. I expect case managers to ﬁrst do no harm while consistently promoting the patient’s needs, no matter the payer. I expect case managers to make a diﬀerence for all the Franks we touch. If health care is to become safe, timely, eﬀective, eﬃcient, equitable, and patient-centered, it will take a case manager to light the path. Steve Jobs once said, “Here’s to the crazy ones. The misﬁts. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things diﬀerently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do.” I believe care coordination can change health care delivery in America and I know case managers can do it if we truly lead the way. Again, thank you for working in partnership with the leadership and staﬀ of CMSA to advance the practice of case management. ■ Nancy Skinner, RN-BC, CCM CMSA President, 2012-2014 This article is dedicated to all the health care providers who have gone above and beyond to make a diﬀerence for all the Franks in this world. 1 Scott II, R. Douglas. “The Direct Cost of Healthcare-Associated Infections in U.S. Hospitals and the Beneﬁts of Prevention” www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf 2 Adverse Events in Hospitals: National Incidence Among Medicare Beneﬁciaries U.S. Department of Health and Human Services, Oﬃce of Inspector General 3 Medicare To Penalize 2,217 Hospitals For Excess Readmissions www.kaiserhealthnews.org/ Stories/2012/August/13/medicare-hospitalsreadmissions-penalties.aspx CMSA President’s Letter continued from page 7 Index of Advertisers AIR AMBULANCES Aviation West Charters Inc dba Angel Med Flight ...................................4 www.angelmedﬂight.com CASE MANAGEMENT GENEX Services, Inc. ............Inside Back Cover www.genexservices.com DRUG & CLINICAL INFORMATION RESOURCES AstraZeneca .......................Outside Back Cover www.azandme.com EMPLOYMENT OPPORTUNITIES (CARE TRANSITIONS COORDINATORS) Amedisys ......................................................17 www.amedisys.com HANDICAP ACCESSIBLE EQUIPMENT Amramp ................................Inside Back Cover www.amramp.com LONG-TERM CARE FACILITIES Kindred Healthcare, Inc. ................................17 www.kindredhealthcare.com REHABILITATION SERVICES Rainbow Rehabilitation Centers ....................12 www.rainbowrehab.com TRANSPORTATION Critical Care Medﬂight ........... Inside Front Cover www.ccmedﬂight.com http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf http://www.kaiserhealthnews.org/ http://www.angelmedflight.com http://www.genexservices.com http://www.azandme.com http://www.amedisys.com http://www.amramp.com http://www.kindredhealthcare.com http://www.rainbowrehab.com http://www.ccmedflight.com http://www.cmsa.org

Table of Contents for the Digital Edition of CMSA Today - Issue 2, 2013

President's Letter
Role of the Nurse Care Manager in a Patient-Centered Medical Home
Association news
View from Capitol Hill
Case Management and the Law
Ethics Casebook
Mentoring Matters
CMSA Corporate Partners
Index of Advertisers

CMSA Today - Issue 2, 2013