Case Management & Social Work Magazine

PATIENT CARE • CASELOADS • WELLNESS • PROFESSIONAL DEVELOPMENT

“

Improving

and Restoring Mobility and

Helping People Achieve Their Goals.

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ELEVATE CARE Celebrates National Nurses Nursing Home Week

Amidst the COVID-19 pandemic that magnifies the challenges we face on a daily basis, there is no better time than now to celebrate National Nurses Week and Nursing Home Week, May 10-16, 2020. Much to our dismay, the Skilled Nursing arena receives disproportionate amount of negative press concerning the spread of Coronavirus throughout its communities.

What gets over shadowed during this arduous time is the word hero and the depth of its meaning to those that are employed within skilled nursing facilities. It is even more of a priority to underscore the brave and selfless acts performed daily by the heroes at Elevate Care, located in the Chicago Suburbs. These Heroes heed the calling and commitment to care for our patients. Their remarkable display of compassionate, courageous care is unparalleled.

During Nurses and Nursing Home Week, Elevate Care has launched a companywide initiative to ensure that each and every employee and patient was celebrated within their facilities. From fiestas and carnivals to barbeques and giveaways, fun was had by all. Some may ask, how do you celebrate in a time of worry and fear? The answer is simple. There is so much to celebrate within the walls of Elevate Care. It’s the love and compassion that occurs each day. Times are tough, without a doubt, but the actions of our heroes on the frontlines will continue to drive this organization’s fight against the virus. Together, we will overcome Coronavirus.

To inquire about short-term rehabilitation or long-term care, please email info@elevatecare.com or visit www.elevatecare.com Locations Include: Elevate Care Riverwoods * Elevate Care Niles * Elevate Care Northbrook Elevate Care Chicago North * Elevate Care Waukegan * Elevate Care Irving Park

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PERFECT FIT: E XCEP T I ONAL C AR E I N A BE AU T I F U L CO MM U N I T Y. With all private residences at all levels of care, The Carrington at Lincolnwood offers a progressive approach to Assisted Living and Memory Care. This includes highly customized care plans for each individual. Plus, our purpose-built community features innovative design elements—creating an uplifting environment for both residents and their families.

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Spring 2020

CONTENTS

Our Specialty Acute Care Services Include:

8

• Pulmonary/Ventilator/ Tracheostomy Services • Complex Wound Care

COVER FEATURE 8

• Multi-System Complications

Scheck & Siress Prosthetics and Orthotics Are Committed To Quality and Care

• Medically Complex • Cardiac Services • IV Therapy

DEPARTMENTS

• Renal Failure/Dialysis

2

Editor’s Corner

5

Wellness Benefits of Superfoods

6

Caseloads Manage Your Patients Dignity

20

Case Manager Highlight CMSA Chicago President, Colleen Morley

FEATURES 17 Palliative Care and Why It’s So Important In The

Wake of The CoVID-19 Pandemic with Dr. Kuljit Kapur, Chief Medical Officer for

Transitions Hospice.

19 Role of Professional Advocate vs. Case Manager:

What’s the Difference? with Teri Dreher, RN, iRNPA, CCM, Board

Certified Patient Advocate and

Owner/CEO NShore Patient Advocates, LLC

Linda Del Bosque

Editor in Chief

Aaron Foster

Graphic Designer ilcmsw.com | 847.863.1174

Copyright Case Management & Social Work Magazine, All Rights Reserved.

No part of this magazine may be reproduced or transmitted in any form or by any means without written permission from Case Management & Social Work Magazine.

9509 Georgia Street Crown Point, IN 46307 www.vhnwindiana.com 219.472.2200

Editor’s Corner

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elcome to Case Management & Social Work Magazine. I have made a full circle in finding a passion to share, engage, and bring forth valuable information to each of you. As we grow into a level of accountability to bring forth resources for a sustainable plan of care, I welcome each of you to share your vision, passion, and dedication to patient care.

I come from the field of publishing, and when the time presented itself to relaunch the idea of connecting both the begin and end user through grass roots publishing, it was an amazing opportunity. In the mid 2000’s, I helped develop Texas Case Management Magazine. I published a senior life magazine in the Dallas-Fort Worth area. I sold the magazine, and left my position at Texas Case Management.

Years later, I have circled back to the state I now call home- Illinois. I attended college in Chicago in ‘96, and knew one day I wanted to return to doing what I enjoy, connecting companies to grow their outreach.

I would like to welcome CMSA and CMSA Foundation.

Case Management & Social Work Magazine looks forward to working with such a dedicated organization that has been changing the landscape of patient care for many years.

In this issue, we have the honor is getting to know Chicago CMSA President, Colleen Morley. Colleen has been light in my eyes in short amount of time. Her presences in her work are visible through her leadership. I look forward to with Colleen and learning more about Chicago CMSA. On page 19, “Role of Professional Advocate vs. Case Manager” outlines the benefits in working with professional advocates. As the needs of patients are personalized, creating a safe space with educated professionals who know and understand and will be able to meet the needs of your patients.

We provide holistic care for patient and family to optimize quality of life at its end stage

Provides holistic care for patientWeandprovide family. an experience of

losing a love one with Comfort, Dignity and Serenity.

Endeavor to provide an experience of losingoptions, a love onerespects We offer wishes free from fear andandpainsupport decisions of patient and family in relation to hospice care.

WebSite: Serenityonehospice.net Phone: (630) 953-2018 Linda Del Bosque Editor in Chief linda@ilcmsw.com

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Rehabilitation & Post Acute Care 500 W. McKinley Ave., Decatur, IL 62526

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The Health Benefits of Superfoods Eating a nutritious diet rich in vitamins, minerals and antioxidants is one of the most important parts of living a healthy lifestyle. Science says nutrient-dense foods not only make you feel great, but may even reduce your risk of certain chronic health conditions while providing multiple health benefits.

You’ve most likely heard the term “superfoods” to describe foods that will supposedly make you look great, feel great and help you live a longer, healthier life — but what are “superfoods” and what makes them so super? We’ve taken a look at these so-called superfoods to see what about them packs that extra nutrient punch and how you should incorporate them into your everyday diet.

What Is A Superfood?

There is no exact definition of what makes a “superfood.”

However, superfoods are considered to be nutrient powerhouses that provide large quantities of antioxidants, phytochemicals (chemicals in plants responsible for colors and smells), vitamins and minerals. Most superfoods are plant-based, but some fish and dairy also make the cut.

Examples of popular superfoods include salmon, kale, açaí berries, kefir and almonds, just to name a few. Since there is not a strict definition of superfoods, any food that is nutrientdense is commonly put into this category.

WELLNESS Fiber, which is also found in many superfoods, can help prevent diabetes and digestive problems while phytochemicals have numerous health benefits including reducing your risk of developing cardiovascular diseases.

Superfoods are also known to protect your organs from toxins, help lower cholesterol, regulate metabolism and reduce inflammation Eating A Well-Balanced Diet It’s important to note that while superfoods are good for your health and provide many nutrients you need on a daily basis, eating superfoods alone does not contribute to a healthy diet. Eating too much of one type of food can actually be detrimental to your health and prevent you from getting all of the nutrients you need. For this reason, superfoods should be added to a well-balanced diet, not replace one.

“No one food can provide you all of the essential vitamins, minerals and antioxidants you need,” says INTEGRIS dietitian Meagan Ballard. “It is very important to eat a wide variety of nutrient-rich foods to obtain the health benefits our bodies need. There is nothing wrong with eating a food item that provides you a good amount of a specific vitamin or mineral that you need, but our bodies require many vitamins and minerals to function properly, so don’t rely on one superfood alone to achieve this.”

A well-balanced and nutritious diet should include fruits, vegetables, lean protein, whole grains, legumes and nuts while limiting the intake of sodium, bad fats and refined sugar. When combined with exercise and regular physical activity, a healthy and nutritious diet can work wonders for your health. As Ballard says, “Food IS medicine.”

Superfoods make a nutrient-packed addition to a wellbalanced diet and regular exercise routine. For more nutrition and fitness tips, check out the INTEGRIS On Your Health blog.

Benefits Of Superfoods The high vitamin and mineral content found in superfoods can help your body ward off diseases and keep you healthier.

When incorporated into a well-balanced diet, these foods can promote heart health, weight loss, improve energy levels and even reduce the effects of aging.

Antioxidants found in many superfoods may help prevent cancer, while healthy fats can reduce your risk of heart disease.

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CASELOADS

Don’t Forget To Manage Your Patients’ Dignity Just before I induced anesthesia, he said, “Doc, I want to apologize beforehand.

I am incontinent due to a previous surgery so I might wet the sheets.”

I told him not to worry and that we understood and that “these things do happen.” His response has stuck with me: “Doc, but there is still some shame.”

I nodded, told him not to worry since he was going to get a catheter anyway, and started pre-oxygenating him.

I thought about his words all day. He was right.

We who work in the hospital setting expect our patients to check their feelings of shame at the door. What we fail to remember is that this feeling of shame is linked to a very major intrinsic human value called dignity. Loss of dignity for most people results in a lot of consternation, and yet, we expect our patients to check theirs at the door.

Dignity is seen as the right to being seen as worthy — to being respected and valued. It comes from the Latin word “dignitas,” meaning “worthiness.” It is a very powerful human need to be treated with dignity and respect. It is also appreciated when one carries himself or herself with dignity.

The hospital can absolutely rob one of his or her dignity. From gowns that expose the backside to the total lack of privacy, there is a constant assault on patients’ dignity, leading to shame.

Now that is oftentimes a factor of the helplessness that illness and even age brings. That may make one incontinent, bringing on the shame of wearing diapers or even getting cleaned like a little child. Then are the necessary exams and treatments that can be invasive and

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demeaning. Pain always hovers around the corner, making patients helpless and dependent. It is also not uncommon to have doctors barge into patients’ rooms and not even introduce themselves. The whole stay at a hospital is enveloped in fear, and this just worsens the “dedignification” process.

So besides the shame, does it really matter if patients lose their dignity for a few days?

Of course, it does, and yet, in a lot of hospitals the world over, the sick are not allowed the dignity they deserve.

Maintaining patient dignity has been shown to improve outcomes. In surveys done by the World Health Organization (WHO) in 41 countries, dignity was the second most important care attribute participants picked — only “promptness of care” was more highly rated.

Dignity matters and helping our patients maintain theirs should be high up on the list of every doctor and nurse.

The first step is to create awareness among all doctors and nurses about the importance of our patients’ dignity.

Turnock and his group showed in a 2001 study that “awareness among the staff and nurses of the factors that promote patient dignity prompts all personnel to better maintain the personal dignity of patients.”

Then comes the environment that we create for the patients. The human element is important. A listening ear, empathy, and kindness can go a long way. The physical bit needs to be appropriate too. Gowns that reveal the backside of patients are not always necessary. A Canadian study from 2014 showed that although 56 percent of the patients could wear pants without

causing a medical problem, only 25 percent of these patients actually did or were allowed to. Privacy is also of importance.

The physical environment segues into the importance of meeting the needs of patients. Of course, some demands may be outlandish, and in today’s environment of nurse shortages, not all demands can be met.

So that is where a third important point comes in — communication.

Not only is that important in dealing with patient needs, but it helps in discussing the illness they have, necessary tests, treatment options, prognosis, and even discharge instructions.

Lastly, is the importance of involving patients’ families.

The solutions listed above are in no way exhaustive. I have just listed a few more common ways of dealing with the problem.

In the “Nicomachean Ethics,” Aristotle wrote: “The ideal man bears the accidents of life with dignity and grace, making the best of circumstances.” It would be great if all our patients were like the Aristotelian ideal person, but as life would have it, they are not. Thus, it is up to us to help them maintain their sojourn with us with dignity and grace.

Editor Nana Dadzie Ghansah is a cardiac anesthesiologist.

CMSA Chicago

Presents The Annual Conference,

2020

What’s Your Vision?�

Case managers and healthcare professionals gather together to learn share and grow.

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The Patient-First Philosophy has Changed

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Darrius’ Life with

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hen Darrius was injured at work in 2017, his life took a dramatic turn. Laying in a hospital bed, and forced to reconsider his path forward, he admits his journey started at an all-time low point.

“I didn’t even believe it at first. When I got hurt I was depressed, so much so, that I didn’t want to live. I thought life was over. I cried all Thursday before my surgery when the doctor said it would be at least a year before I could walk again.”

In the midst of his recovery, Darrius met a practitioner from Scheck & Siress, Tom O’Doherty.

“I said to myself, you know what, I’m determined to walk in six months. I met Tom, who told me he could get me back to walking in four weeks! I felt really comfortable with him, and when we started the process he said ‘just trust me.’ This guy went above and beyond. He came to my home and met with me and my family. His work is impeccable and he’s passionate. I was injured in July of 2017, and Tom fitted me in September of the same year, and got me upright. Once I took those first steps I was like, it’s on now!”

Tom O’Doherty immediately understood what needed to happen to help Darrius achieve his goals.

“When Darius arrived at my clinic I was surprised as I met him prior to him getting a prosthesis and he had gone to another clinic, but was not satisfied with the care he was receiving. He was uncomfortable in his socket, which wasn’t as secure as it should have been. I focused on his immediate needs and fit him with a dynamic prosthesis, which he really loves.”

Now that Darrius was upright, mobile and eager to work, he faced a new reality and was unable to return to the job he previously held. Instead of allowing this fact to discourage him, he turned his focus to something he’d always wanted to be a barber.

“When the accident took away my livelihood, I was like, what am I going to do now? I loved to cut hair, but I wasn’t serious enough about it to make it a career. I thought to myself I have to show my six kids that you can always bounce back, and that nothing can hold you down. I researched and signed up for barber school, then I set some goals; to be on my feet, to be my own boss. I’ve now accomplished those goals, but the greatest satisfaction is I took a situation that could’ve killed me and now I’m doing what I always wanted to, because of Tom and Scheck & Siress.”

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Tom O’Doherty says he joined Scheck & Siress because of their commitment to patients and willingness to go the extra mile.

“I have been working for Scheck & Siress for 7 years.

What inspired me to join the company was meeting John Angelico, Mike Oros and Jason Wening. Right away I could tell this company was patient-focused and its practitioners could inspire people to achieve more. The status quo was not good enough, and I wanted to be a part of those values and add to them.

I have worked in London, Chicago and Washington, DC and the people I work with now are the best I have ever met. Scheck & Siress has a very unique partnership that celebrates collaboration with the over 40 prosthetists and orthotists who have the common goal of getting the patient where they want to be.”

While the patient-first philosophy of Sheck & Siress has changed Darrius’ life, it is comically bittersweet for Tom O’Doherty.

“Darius has thrived since receiving the prosthesis and is able to run after his kids even after standing all day

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for his job as a barber. The only issue we have now is he’s always talking about my horrible haircut. I’m bald so there’s not much I can do.”

We look forward to helping your next patient.

Contact our professional team at 847.558.6758 michaelangelico@scheckandsiress.com

Supporting Senior Orphans Struggling in a Complex Healthcare System

Our team of registered nurses, social workers, attorneys, case managers and non-medical administrators provide a wide spectrum of services to disadvantaged seniors with no family.

Seniors Alone Guardianship and Advocacy Services (SAGAS), a 501C3 charitable organization, was formed in 2019 to provide patient advocacy and guardianship services to two vastly-underserved groups: low-income senior citizens and adults with disabilities who lack adequate family support.

Our team of highly-skilled professionals work together to protect patients’ rights and ensure high-quality care. We collaborate with healthcare providers, the courts and long-term care resources to achieve superior patient outcomes.

Through the generous support of sponsors and donors, we ensure that more of those who can’t navigate our complex healthcare system alone receive the services they need.

LEARN MORE ABOUT US Visit our website SeniorsAlone.org to learn more about our new organization and what we do.

JOIN OUR MISSION Help us help more people in need! Make a donation at SeniorsAlone.org Our founder, Teri Dreher, RN, CCM, is an experienced critical care nurse, Board Certified Patient Advocate (BCPA), and owner of NShore Patient Advocates, Chicago’s largest private professional patient advocacy company.

SeniorsAlone.org

• info@seniorsalone.org

• 312-826-9204

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225 W Washington St. Suite 2200, Chicago, IL, 60606

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Weiss Memorial 
 Hospital

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Transitions Hospice & Palliative Care

West Suburban Medical Center's Subacute Rehabilitation

Talking about continence care issues can be difficult, getting free supplies is not.

What We Do Aeroflow Urology helps your patients receive high-quality continence care supplies at no cost through their Medicaid benefits.

How It Works A dedicated Continence Care Specialist connects with your patient to determine the best products to suit their needs and establishes a one-to-one relationship that will last through the duration of their care.

The dedicated Aeroflow Urology Specialist will contact your patient’s insurance provider and doctor, take care of all necessary paperwork and answer all of your patient’s questions.

Your patient’s order is filled and their shipping and tracking information is immediately sent to them. Products are packaged discreetly and delivered to their home each month as allowed by insurance.

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8/6/19 6:20 AM

Palliative Care

Why It’s So Important In The Wake of The CoVID-19 Pandemic Uncertainty has classified our recent times. Social distancing and flattening of the curve globally are being utilized to mitigate the mortality rate and control the resource needs during this unprecedented crisis.

E-learning is being practiced in schools and universities, birthday and graduation parties cancelled, airports are being closed and even funerals are needing to be held online, not to mention patients are dying alone in hospitals. Within many uncertain moments of the pandemic, palliative care has been the hidden tool to face the multifaceted issues that arise. It is being utilized as it should: for patients with serious illness where medical intervention can cause more harm than good.

Palliative care offers more than meets the eye. This element of healthcare provides a window to deliver quality at such a delicate and crucial time. Advocacy in areas of goal making, legal, financial, social, psychological, spiritual and physical concerns are accomplished within the palliative care framework. It’s a safe place for patients and families

to be heard and valued, in addition to fostering collaboration with their medical teams. Coronavirus can cause rapid deterioration, so the demand for protocols for advanced care planning are in demand at this time. Palliative care hotlines and mobile units have become the new innovations to address the surge of consultations. Stockpiles of comfort medications such as morphine, scopolamine, and midazolam are being supplied together and essential.

COVID-related pneumonia, and the variable clinical manifestations we are seeing in different age groups, requires expert management of fever, dyspnea, upper airway congestion, nausea, anxiety and delirium. Telemedicine has reduced infection and improved efficiency of healthcare delivery.

With symptoms managed we can then address caregiver grief and better support patients with marginalized populations, including the homeless, incarcerated and Indigenous, those most at risk for being underserved. During this pandemic, equital healthcare and autonomous decision making are threatened in the realms of

election of life prolonging therapy in intensive care units, hospital wards, emergency departments, and longterm care settings.

Palliative care also lowers societal and healthcare costs by $3K per palliative consultation. My palliative care teams have led to $7 million dollars of cost savings, reduced readmission rates from 22% to 6% in nursing homes, and compassionately served thousands of patients toward quality of life and dignity, no matter where they are in the progression of their illness.

People start feeling better right away when they can make well informed decisions and have their worsened symptoms managed well. Palliative care is a human right and serves humanity well when integrated into hospital systems.

Dr. Kuljit Kapur is the Chief Medical Officer for Transitions Hospice serving 38 counties in Northern Illinois.

For more information on Palliative Care or Hospice, please call 877-726-6494 or visit www.transitionshospice.com.

References: https://www.clinicaloncology.com/COVID-19/Article/04-20/Palliative-Care-s-Evolving-Guidelines-During-the-COVID-19-Crisis/58274 https://www.cmaj.ca/content/cmaj/early/2020/03/31/cmaj.200465.full.pdf https://www.forbes.com/sites/sachinjain/2020/05/03/palliative-care-the-secret-weapon-hiding-in-plain-sight

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RLY E RM ADO O F ER ITIES V L SI MUN M CO

WELCOME TO

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For more information, call or visit us today!

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Role of Professional Advocate vs. Case Manager: What’s the Difference?

By Teri Dreher, RN, iRNPA, CCM, Board Certified Patient Advocate | Owner/CEO NShore Patient Advocates, LLC Everybody needs a patient advocate. That’s the message the American Heart Association conveyed in their publication Heart Insight (Caswell, 2015). Indeed, with America’s increasingly complicated healthcare system, more and more inpatient case managers are finding that what the AHA said is true, and as a result, they are turning to patient advocates to help manage post-discharge care of patients with complex comorbidities who are at high-risk for readmission.

Community-based private professional RN Patient Advocates are experts in community resources and oversight the same way hospital case managers are experts at case management in the acute care setting.

In fact, community-based RN Patient Advocates have a very similar role that community-based RN care mangers do. It is not “reinventing the wheel” as some have posited. Both professions have patient advocacy as a core value but there are some subtle but important distinctions that are important to patient centric care models. Understanding these will help both work more collaboratively for the patient’s benefit as well as the hospital’s on several levels.

A good professional patient advocate empowers individuals or families to make informed choices by educating them about the patient’s medical conditions, asking physicians questions the patient wouldn’t know to ask and researching a patient’s full range of treatment options. They also act as a liaison between patients and

providers, looking out for a patient while they are receiving treatment and ensure that insurance and billing disputes get resolved quickly. Since all of these are tasks that community care managers are involved in, let’s take a look at some of the differences and similarities between the two professions.

First of all, the field of professional patient advocacy has only officially been in existence for about 10 years, whereas case/care management is a much more mature field that has existed for over 25 years. Professional advocacy has been growing due to an increasing sense of consumer alarm over high rates of medical error, frustration and confusion over our rapidly changing healthcare system.

Quite frankly, patients hire this group to advocate and fight on their behalf; someone to stand in the gap and make certain their personal interests are protected. To advocate essentially means to represent the needs of another. Patients understand the allegiance factor that separates case managers who work for institutions from those who are privately paid by the patients themselves.

Yes, community care managers are often privately paid as well, although in many cases, professional advocates get involved when patients do not only need someone to manage their healthcare, but advocate strongly on their behalf, either with insurance companies, vetting the best providers for rare disorders or even standing up for them in ethical challenges within hospitals. We do essentially the same thing that any good nurse or social worker does for Continue to page 20

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their own family when healthcare crises occur; we are just paid privately by our clients for these valuable services.

When cost savings and what is best for the patient collide, there are often ethical dilemmas that are difficult to mediate when case managers in hospitals get paid from that hospital. Advocates have a primary goal of protection: patient rights, health and prevention of medical error due to miscommunication through transitions of care.

Patients are today receiving more care outside the acute care setting than inside, and they are more complex, with fewer family caregivers available to manage their complex needs. Since advocates often have long-term relationships with clients, they know what their premorbid conditions are and can share a more balanced view of what is normal for clients. That is the reason why the field is growing so rapidly and should not be dismissed by traditional healthcare providers, or case managers.

I recently took and passed the CCM exam myself and was impressed by how similar the industry standards and codes of ethics are.

The industries are not adversarial; each want the same thing in the end: safer, more patient-focused higher quality care and reduced readmissions to hospitals, with lower rates of medical error. Any nurse or social worker who has worked for a hospital can tell “stories from the front”.

Knowing where the gaps and potential for harm is helps us navigate the patient around frightening moments where the wrong decision can result in life or death. In 90% of the cases when I have been called into a hospital crisis, the real problem is miscommunication. Patients and families will be more likely to believe an advocate, even when we confirm the doctor’s suggestions and treatment plan because we are being paid privately by the client. In most cases, we provide benefit to both sides but we “belong” to the client alone, who pays us. RN Patient Advocates are experts at chronic disease management and oversight of complex clients. Hospital case management teams rarely go out into the community: we go where they simply cannot go.

For case managers, RN Patient Advocates can be a vital link in providing better outcomes for patients. Medical error is the third leading cause of death today, according to a study by researchers at Johns Hopkins University School of Medicine (Makary and Daniel, 2016). The pressure on case managers to move people through the system and complete reams of paperwork can make it difficult to catch errors. That’s one place where patient advocates can help fill in the gaps. They can help case managers understand the complex issues patients face at home or make them aware of the “little white lies” patients may tell just so they can go home to an unsafe living environment.

They are also intimately aware of the variances in quality

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between the different subacute skilled facilities and poor-quality home care agencies and can guide clients to the higher quality settings and providers, avoiding needless complications and improving outcomes for all..

It’s important to remember, though, that not all patient advocates are created equal. Some may not have any professional licensure or clinical healthcare experience beyond their advocacy training or advocating for a family member in a particular situation. To find someone with more expertise in handling medically fragile, complex patients, it’s best to look for an RN Patient Advocate, and a company with the capacity to accept higher volumes of referrals. These Advocates are often veteran Registered Nurses with experience in bedside patient care. They understand and empathize with the challenges that hospitals face today and can make case managers’ jobs easier. National certification and graduate training in the field can also signal someone who is more knowledgeable about advocating for patients. About 20 U.S. universities now offer graduate certificate programs in private patient advocacy.

National certification became available this year via the Patient Advocate Certification BoardTM, which conducts a rigorous exam spanning a broad spectrum of patient advocacy areas.

Those who pass earn the credentials “BCPA”—Board Certified Patient Advocate. BCPA’s work in a wide variety of hospital and community settings and may or may not have professional licenses in the healthcare field. A National Patient Advocacy Conference is slated to present in the Chicago area in the fall of 2019.

Rather than a hindrance to case managers, patient advocates are often seen as a time-saver. We once had a client referred to us by a local church with alarming memory impairment. The police found her wandering in the community, disoriented and unable to state her address. They took her to the local ED where she became combative and was unable to give any meaningful history, with no family in the area. When a friend called the church, I came to the hospital and shared critically needed information and spent eight hours contacting multiple memory care facilities who would take her that day (a holiday) , which was very valuable to the hospital since the patient was medically stable; a safe discharge plan was of benefit to everyone concerned, and her family flew in to assist her when I contacted them later that day. Also, a case manager can communicate information to a patient advocate in five minutes that might take him or her 20 minutes to communicate to a patient or family member. That’s a plus to both sides. It saves time for the manager and leaves the patient more time to understand what is

going on and get a clear understanding of their options from an unbiased source. A patient advocate will give a patient the whole picture, not just the one that is the most financially beneficial to an insurance company or what their families are pressing them to do. Everyone has options, no matter how serious their condition. We focus on patient centric care in a very holistic way and follow clients throughout every care transition, much like a family member would do. At our company, we are available to our clients 24/7, much like “having a nurse in the family”. We do not carry the caseload that most case managers do due to the acuity and medical complexity of our clients; at most we carry 8-10 clients each, with one or two in an acute medical crisis that may require daily hospital visits. Our computer time is much decreased as we are not under insurance company or Medicare regulations. Though we are HIPAA compliant, our record keeping is succinct and we can spend more face to face time with our clients: something many patients are craving today.

A patient advocate can also provide follow-up to help with a patient’s care. Anyone who has ever listened to a doctor’s instructions in their office only to forget the details of those instructions when they get home understands how important this is. So, too, do those trying to manage a family member’s care from out-of-state. The patient advocate can provide the patient with more in-depth instructions when necessary, monitor compliance and watch for side effects of medications. And when they are monitoring patients in their homes, they can often catch the early signs of trouble and get them medical help before the health issue escalates to a health crisis.

One of the many challenges facing case managers today is how to help patients who can’t manage their own physical care. Some are “senior orphans,” elderly and alone. Others are reeling from a crisis or diagnosis that’s beyond what they can handle. Many have families who are too far away or too busy to handle complex caregiving needs. Sometimes, if a medical practice incorporates regular travel to nursing or senior residences to see patients who often are unable to advocate for themselves, the doctor may feel helpless and frustrated.

Having an RN Patient Advocate on the case is like having a midlevel practitioner in the community they do not have to pay for, as some doctors have told us.

Either way, there is a straightforward solution: connect to a local RN Patient Advocate and find out more about what they can add to the transitional plan of care.

In today’s world of healthcare, we all need to work together to achieve better outcomes and improved patient satisfaction. Experienced nurse advocates are

trained to guide patients through the healthcare maze, coordinating with the case manager and the doctors to ensure they receive proper care. Patient advocates collaborate with case managers and best of all, they are paid solely by the patient/family—there is no cost to the management practice. It is a win:win for patients, providers and hospitals. Think of a patient advocate as a case management healthcare partner rather than an adversary—someone who focuses on navigating treatment and care so their clients can just focus on getting better. It leads to more peace of mind for everyone.

150 S Wacker Drive #2400, Chicago, Il 60606 Telephone: 847-612-6684 Fax Number: 847-680-0934 Email: Teri@northshoreRN.com

Teri Dreher, RN, iRNPA, is an award-winning RN patient advocate and a pioneer in the growing field of private patient advocacy. A critical care nurse for more than 30 years, today she is owner/founder of NShore Patient Advocates, the largest advocacy company in the Chicago area. She was awarded her industry’s highest honor, The APHA H. Kenneth Schueler Patient Advocacy Compass Award and was recently among the first to be awarded professional certification by the Patient Advocate Certification Board. Her book, “Patient Advocacy Matters,” is now in its second printing. www.Northshorern.com

References

Caswell, J. (2015, Fall). Why Every Patient Needs an Advocate. Retrieved from http:// heartinsight.heart.org/Fall-2015/ Makary, M., & Daniel, M. (2016, May 03). Medical error-the third leading cause of death in the US. Retrieved from https://www.bmj.com/content/353/bmj.i2139 Makary, Martin A, and Michael Daniel. “Medical Error—the Third Leading Cause of Death in the US.” BMJ, 2016, p. i2139., doi:10.1136/bmj.i2139.

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Case Manager Highlight

Colleen Morley, DNP RN CCM CMAC CMCN ACM-RN Director of Case Management | West Suburban Medical Center President 2019-21 | CMSA Chicago How many years have you been a case manager?

As President of the CMSA Chicago chapter what have you enjoyed the most being in your position?

16 years. Started in CM in 2004, I have worked in Managed Care and Acute Care settings for the most part.

What hospital did you begin your career?

Started my nursing career at Mt Sinai Hospital 2 weeks after graduation from South Suburban College School of Nursing. First CM job was at BCBS IL for 5 years, where I started as Care Coordinator I and was eventually promoted to Manager of Health Services. In 2009, I joined the team at Provena Mercy Medical Center in Aurora, IL for my first hospital based CM position as Manager/Director of Case Management.

What is one thing you have learned in the last three years of your professional career that you would like to share with other case managers? (Advice, tips..etc) Don’t be afraid to think outside the box. My best ideas/solutions come from playing “what if ” and working backwards from best outcome to current state, identifying solutions and barriers along the way.

Change is not a bad thing.

It’s uncomfortable but the ability to grow is unparalleled.

Don’t stop learning!

Participate in formal and informal learning opportunities; explore new areas. Look into some new topics within your chosen field but don’t limit it to strictly professional education. For example, I am exploring some creative outlets, like glass blowing and cooking lessons. You would be surprised at how the skills and lessons you learn can help you grow in your professional life.

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Why do you enjoy being a case manager?

Case Management is the perfect combination of all my life’s careers (finance, nursing). Case managers are uniquely poised to see the BIG picture (population health, system financials) as well as the impact at the individual level (patient specific, social determinants of health). We use our skill set to create best outcomes for all involved. I can think of no better career in healthcare and it’s a miracle I found it (or it found me) by accident. Case management is the best kept secret in healthcare and we need to get the word out to the world!

If there was one thing that you can change the healthcare industry to improve patient care what would that be?

The emphasis has to be on patient centered care and patient engagement/ activation.

The healthcare system does not do a very good job of educating patients at their level, teaching them the way they prefer to learn and including “their team” in the experience. Goals are not necessarily patient goals, but rather what the healthcare team wants for outcomes. This is why case manager RN & SW are so integral to the team.

They are the ones who often remind the rest of the team about the “person” in the middle of this health crisis.

The ability to support case manager RNs and SWs in their professional development, collaboration and being the “cheerleader” for case management in the Chicago area.

Expanding our support to the NW Indiana area, providing monthly education/ networking events, other timely educational opportunities (such as being the 1st professional organization to provide the new, required Workplace Harassment CE). I just love this group, what it stands for and the community of case manager RNs and SW. I’ve made some lifelong friendships with people I would have never met otherwise.

How exciting is it to oversee and lead a group of case managers and work with them at CMSA Chicago?

It is impossible to convey in words how exciting being President of CMSA Chicago is to me. I am surrounded by incredible healthcare professionals across the continuum of care who are willing to share their ideas, experiences and expertise. Can it get any better for a frustrated professional student?

The membership of CMSA Chicago are diverse, unique, knowledgable and powerful. The BOD of CMSA Chicago are incredible powerhouses in all areas of patient care and bring endless energy and ideas to the table to make the CM community in Chicago one of the most vibrant in the country. We have grown over 180% in the last 2 years, sold out our 2019 conference and look to be selling out the 2020 conference. We are booked out for meeting sponsors through 4/2021. The world is getting to know what I have known for years: CMSA Chicago is something very special! I am honored to be in this position and thank the membership for the opportunity.

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Through generous support of our donors, the CMSA Foundation provides case management scholarships, grants, and recognition related to education, advocacy, and best practices to CMSA members.

Will you be our next recipient?

Visit us at the CMSA Annual Conf in Boston, Jun 29-Jul 1, 2020! web: www.cmsafoundation.org

email: foundation@cmsa.org

The CMSA Foundation is a charitable, not for profit organization created to support education, research, and career development for case management professionals. The CMSA Foundation supports the members of the Case Management Society of America (CMSA), a professional association for multiple case management disciplines, including nurses and social workers.

Improve Your Performance at Work in 4 Easy Steps You can do many things to improve your performance at work, things that don’t occur to most people.

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