Case Management and Social Work Magazine

PATIENT CARE • CASELOADS • WELLNESS • PROFESSIONAL DEVELOPMENT

CASE& SOCIAL WORK MANAGEMENT

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WINTER 2021

CONTENTS CASE MANAGEMENT & SOCAL WORK MAGAZINE

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Linda Del Bosque EDITOR IN CHIEF

AARON FOSTER ART \ GRAPHICS Brianna Riza LEAD DIRECTOR

OFFICES \ GROUPS ARIZONIA N. ILLINOIS MID-ATLANTIC REGION SUPPORTING ORGANIZATIONS CMSA FOUNDATION CMSA ACMA LINDA@ILCMSW.COM 847.863.1174

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The information on this site is for information purposes only.

Case Management and Social Work Magazine, LLC and. assumes no liability or responsibility for any inaccurate, delayed or incomplete information, nor for any actions taken in reliance thereon. The information contained about each individual, event or organization has been provided by such individual, event organizers or organization without verification by us.The opinion expressed in each article is the opinion of its author and does not necessarily reflect the opinion of Case Management and Social Work Magazine, LLC. Therefore, Case Management and Social Work Magazine, LLC carries no responsibility for the opinion expressed thereon. Any form of reproduction of any content on this website without the written permission of the publisher is strictly prohibited. Case Management and Social Work Magazine, LLC is a trademarked company; all rights reserved.

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FOR MORE INFORMATION CMSA.ORG

February 17, 2021

Navigating Personalized Care Celebrating Life 2021

We at Serenity One Hospice believes in the philosophy of care that hospice is living life to the fullest. We support families and we take care of a person whose tomorrow may never come. We explore the affirmation of faith that death may not be the end but a passage towards a new beginning.

Hospice helps the individual with their families to live life at its fullest when dealing with an illness that has no cure or when seeking for cure is no longer an option. Hospice also help an individual and their families address their fear of dying when death is already considered inevitable in the very near future.

Hospice with its palliative program provides services aims to: o

Eliminating if not minimizing pain and discomfort

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Alleviating emotional distress, agitation and anxiety.

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Assisting with safety, mobility and use of medical equipment necessary in the provision of care.

o

Spiritual and social counseling

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Empowering patients and families to make decisions and best options available.

Hospice is a philosophy of care that treats the individual rather than the disease. It focuses on providing comfort and dignity to a dying person as the end of life care. Hospice provides holistic care which encompasses physical, spiritual, social and emotional wellbeing of an individual as well as the families. The goal is not to cure but “relieved the physical, emotional, social burden that may cause the pain and suffering of an individual whose illness has no cure or when the cure is no longer feasible.

Hospice provides support to the individual and their families so they can be physically and emotionally able to focus to make decisions that matters the most.

Hospice recognizes that dying is the normal process of life and the journey of losing a loved may happen with comfort, dignity and serenity.

Thank you to all the Case Managers who work continuously.. Our team hopes each of you enjoyed Case Management Week last month.

Our team passed out Nothing Bunt Cakes during CM Week.

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What to Do and Say to Support Safety During the COVID-19 Pa 8

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t Psychological andemic

COVID-19 is taking its toll on health care workers. Increased patient loads, constant threat of exposure, and the trauma of treating those critically ill with a highly contagious virus — including sometimes one’s own colleagues — is placing staff under immense stress.

The multitude of stressors front line staff face are exacerbating burnout and mental health issues.

Forward-thinking health care leaders saw the evidence of an emerging public health crisis and did their best to plan accordingly. Similarly, the following actions offer suggestions for how to prioritize staff well-being and joy in work now instead of waiting for circumstances to worsen: Listen To Staff And Respond To Concerns About Well-Being.

Leaders from hospitals that have weathered COVID-19 surges report the benefits of connecting with front line workers and understanding how the evolving situation is affecting their well-being. Many leaders have been shifting the dialogue with staff from “what is the matter” to “what matters to you” and enabling meaningful conversations to elicit concerns.

Staff appear more likely to engage with leaders who are accessible, actively listen, openly share their own feelings and demonstrate genuine care for the welfare of others.

These leadership behaviors also promote psychological safety, encouraging staff to speak up if they are worried about their own or a colleague’s physical or mental health.

To deepen understanding of how staff are coping, leaders are gaining insights from multiple sources. These range from survey data to candid discussions about what is keeping people awake at night. This knowledge is then informing targeted well-being interventions and actions to address sources of concern, including regularly replenishing stocks of personal protective equipment, providing sufficient time to recharge, and rotating staff through high-pressure functions.

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Provide Transparent Communication.

Given the uncertainty associated with the rapidly changing crisis, staff are looking to leaders to provide reassurance and guidance. While leaders are not expected to have all the answers, providing honest accounts of what is known and what remains unclear assists staff to make sense of what is happening. Transparency builds confidence and trust during a crisis. It is crucial for leaders to establish real-time communication and feedback mechanisms to remain responsive to staff concerns and learn about what is working well.

Team huddles, shift debriefs, daily situation reports, and wellness rounds are some of the channels being used to enhance communication and alleviate stress.

Virtual options can reach large numbers of the workforce especially with physical distancing restrictions in place.

Leaders have been live-streaming town hall meetings and connecting with staff using their organization’s online social networking platforms. All interactions with staff provide opportunities to express gratitude and acknowledge their valuable contributions during such challenging times.

Promote Mental Health And Well-Being.

Recognizing “you can’t pour from an empty cup,”

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staff caring for patients need system supports which encourage getting quality sleep, eating well, engaging in physical activity, and maintaining social connections.

Instead of simply telling staff to look after themselves, leaders have been engaging in more tangible actions.

Many hospitals have designated wellness spaces where staff can sleep or take a break. To encourage staff to refresh and refuel, some organizations provide “comfort boxes” containing snacks, well-being resources, toiletries, and messages of appreciation. Checklists can prompt staff to reflect on how they are feeling, practice self-care, seek assistance as needed, and check on their colleagues. Leaders who are open about how they tend to their own well-being can also have a positive influence on their staff by role modeling these behaviors.

Offer Support Where, How, And When Staff Need It. Many organizations have ramped up services to support mental well-being. These include employee assistance programs, pastoral care, peer support, clinical psychology, and psychiatric services. Some organizations have offered “psychological first aid” in strategic locations, like cafeterias and staff lounges, to provide easy access. Others have set up 24/7 hot-lines or expanded teletherapy so staff can seek virtual support. Additionally, buddy staffing models and strategies fostering teamwork are helping front line

workers to look out for each other, share their worries, and provide colleagues with support when stressed.

While some staff will actively seek assistance and want to discuss the impact of COVID-19 on their well-being, others may prefer to shift their focus and escape the barrage of pandemic-related information. In response to staff requests, respite rooms are being established — colloquially known as “NOvid rooms” — where colleagues are not allowed to talk about anything associated with the coronavirus.

Organize Ways To Ease Burdens On Staff.

To make the lives of staff easier, leaders have leveraged relationships with community partners and volunteer groups. There has been an overwhelming response from many keen to “care for caregivers” with offers of meals, childcare, pet sitting, errand running, and free parking.

Providing alternative low- or no-cost accommodation has also been well received by front-line workers cognizant of the risk of spreading the virus to loved ones. If staff become unwell or need to take COVID-19-related leave, leaders should ensure timely access to services aiding recovery and cover associated out-of-pocket expenses.

Burnout was an issue in health care before the coronavirus. The current pandemic is further testing the resilience of health care workers around the globe. Health care professionals dedicate their lives to helping others.

To honor their commitment, it is crucial for leaders to support the well-being and joy in work of the health care workforce for the benefit of both staff and patient care.

Lisa McKenzie, BPhysio(Hons), MHA, is IHI’s Country Director, Australia and New Zealand

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“It put me in a tough situation,” Mauro said. “I needed a job, but I couldn’t transfer my [Illinois] license. I had to get a new license just to get a job back in Iowa, which cost hundreds of dollars.”

Illinois might be about to fix some of the problems Mauro faced.

State Rep. Michael Zalewski, D-Riverside, has introduced House Bill 580 that would bring Illinois into the Nurse Licensure Compact. It would allow qualified nurses to obtain a license that would transfer to all 34 states now in the compact or nurses with a multi-state license to practice in Illinois.

Nurses Could See Improved Job Options.

An impending health care worker shortage argues for a bill that would allow Illinois to join a multi-state nursing license compact. Nurses could see improved job options.

COVID-19 stress is pushing health care workers out of the profession, but Illinois was facing a nursing shortage before the pandemic with 52% of its nurses age 55 or older.

The state being one of the few that requires its own nursing license doesn’t help, but a recently filed bill is intended to fix that.

Madalyn Mauro, 24, had problems getting an Illinois license that included lost paperwork and trouble getting someone on the phone. Then there was the mandate to give her fingerprints in person in Chicago.

“I had to drive five hours from Des Moines to Chicago just to get fingerprinted because they wouldn’t accept Iowa prints,” Mauro said.

Mauro has been a labor and delivery nurse at Northwest Community Hospital in Arlington Heights, Illinois, for roughly four months. That is not much longer than the time she spent trying to obtain an Illinois license after graduating from the University of Iowa.

Her classmates breezed through the licensing process in Iowa. When they had their licenses, they also obtained 34 states worth of job options because Iowa is in the Nurse Licenser Compact that allows them to work in any of the member states.

“I wanted to work in Illinois, but [the Illinois license] was very limiting as far as future career options,” she said.

Worse yet, while Mauro was navigating through the interview process with a couple of hospitals in the Chicago area, COVID-19 hit and the hospitals put a hold on new hires.

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“I refiled the Nurse Licensure Compact because I believe that nurses in Illinois should have the ability to use their licensure in surrounding states,” Zalewski said. “The bill is carefully crafted and narrowly tailored to ensure patient safety, and I hope it will advance out of the House this spring.”

Currently, all of Illinois’ neighboring states participate in the compact, which is a double negative for Illinois. The state’s licensing process not only makes it harder for nurses to come to Illinois, it reduces the incentive for nurses to work in Illinois when they know the license won’t transfer to other states.

Those could become serious issues very soon.

Illinois is experiencing an increase in aging baby boomers who are likely to need more health care. At the same time, its roughly 185,000 registered nurses are aging – with more than half of them over age 55, and 27% of nurses planning to retire within five years. Given that wave of retirements, the Illinois Department of Financial and Professional Regulation predicted a nursing shortage within five years, and that prediction was made with 2018 data.

The same shortage was also predicted for about 220,000 licensed practical nurses in Illinois, with 22% near retirement.

Licenses for both RNs and LPNs are covered by the Nurse Licensure Compact, and the bill would add both types of licenses to the compact. Illinois would still maintain its own nursing licenses and recognize existing licenses but would add multistate licensing and recognize compact licenses if the bill passes.

Mauro is eager for the bill to pass.

“I’m all for it,” she said. “Being a nurse is a great career. Being part of the compact allows us to travel to other states without the headache of transferring our license. It’s one less thing to worry about, and it saves hundreds of dollars each time.”

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THE CMSA FOUNDATION INCREASE

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fter launching a new logo and brand in 2018, the CMSA Foundation transformed 2019 with several new programs to engage donors and volunteers.

While one-time donations are a fabulous way to show support, donors now have a choice of joining the Friends of the Foundation, a new recurring donor program that allows donations in smaller but consistent amounts over a period of time. This favorite option allows amounts that are more convenient to donor budgets.

CMSA chapters are key in reaching members. The Chapter Ambassador Program was launched to create stronger communications between the Foundation and chapters through a chapter representative. The Foundation educates the Ambassador who then shares this knowledge to attendees at local events.

The Foundation offers opportunities to show support while shopping. Through the Foundation Product Store supporters can purchase t-shirts, sweatshirts, masks, mugs, etc., to promote the Foundation and case management while displaying their support. All proceeds from these sales benefit the Foundation. The store can be accessed at https://teespring.com/cmsafoundation.

Amazon is a favorite for not only shopping during the holidays but year-round. Amazon donates on all eligible purchases when you identify CMSA Foundation on AmazonSmile as the charity of your choice. Simply shop at https://smile.amazon.com/ch/26-2770924.

The CMSA Foundation relies on your generosity

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to continue supporting CMSA Members with many programs and recognition through scholarships, grants, and case management research & outcomes awards. The number of programs and recipients will continue to grow with the more support given.

In 2019, the Foundation was able to recognize their first recipients of the Case Management Practice Improvement Award and Case Management Research Award. This recognition showcases organizations or individuals who have developed a process or program that demonstrates advancements in the case management practice, or resulted in improved patient outcomes. The information shared from these programs is instrumental in promoting the value of case management. Recipients receive a $1,500 honorarium, and the opportunity to share their results through an article in CMSA Today. In 2021, recipients will also be able to express the results of their program through an all member webinar.

The CMSA Foundation is dedicated to supporting CMSA members in their endeavors to enhance their case management skills, as well as improve the health outcomes of the most at-risk populations with multiple chronic medical needs including behavioral conditions. Support is available to help a deserving member reach these goals through the Integrated Case Management Training Scholarship. This scholarship not only covers the cost of tuition and training manual, but also some travel and hotel reimbursement.

In 2018, the Foundation President Margaret “Peggy”

ES ENGAGEMENT OPPORTUNITIES Leonard designed and provided funding for a public policy grant program through her passion for educating others about issues affecting health policy. Recipients may be awarded between $2,500-$5,000 depending on the program submitted. In 2019, the Foundation awarded the first grantees of the Margaret Leonard Public Policy Grant program. Sadly, the CMSA Foundation lost Peggy Leonard on September 15, 2019 but her spirit and passion for public policy are still honored and reflected through the work of the Foundation and this grant.

Supporters may earmark donations to this grant at www. cmsafoundation.org/mlppg and keep Peggy’s dream alive.

The 2019 CMSA Annual Conference enabled the Foundation to thank and educate potential supporters through several connections including a Poster Presentation, the Foundation Booth, the CMSA Annual Meeting, and closing Awards program. And, we had the pleasure of awarding a travel getaway to a special winner!

We invite you to learn about the CMSA Foundation and to find a program you can get behind and support!

Support comes in many ways by individuals, chapters, and organizations. The Foundation is thankful to each and every form of support.

The Case Management Society of America Foundation is a charitable, not-for-profit, organization created to support education, research, and professional development for case management professionals. For more information, visit www.cmsafoundation. org or email foundation@cmsa.org.

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nd-of-life specialists compassionately gear patients with terminal diagnoses toward their passions, legacy, and unique meaning here on this earth. We medically manage symptoms based on their goals, establishing a unique plan of care with the patient and their family. We accomplish this plan of care with a community of experts in end-of-life medical management, spirituality, and psychosocial work . We must demystify misconceptions about hospice. Patients do not always die very soon, we do not medicate them to death (that is against the law), all meds are not taken away and you can still see your doctors!

We educate and hold patients’ hands when they are most vulnerable. We use the lowest possible efficacious doses of medicine to relieve symptoms like pain, anxiety, shortness of breath, or swelling.

The focus is life, “the how good as opposed to the how long” in our work. Patients who come onto hospice at the right time may live longer because we often see in end-of-life care that “less can be more”. The mind, body, and spirit are focuses of hospice. As we say at Transitions, it’s about living.

The relationships we develop with our patients allow us to walk the path of suffering with them, which was my mission from the beginning, as written in my medical school personal statement in 2002. Families come to us for education, someone to make it okay or to guide them when faced with complex difficult decisions, such as taking a loved one off a ventilator or stopping IV antibiotics. This element of healthcare provides a window to deliver quality care at such a delicate and crucial time.

I will never forget the breast cancer patient who had an aggressive cancer ravaging her arm with tumor burden and infection. She had such a sense of humor, knowing that she could not go to her trailer home this summer because she was too weak. She reset her expectations of herself and agreed her goal was proper pain management, even if it meant some sedation from medication.

I always remember her because she had the best attitude while her arm was almost falling off from a pathologic fracture. I learned that day that life is about attitude, no matter what is happening. She was so brave in the face of adversity, keeping her spirit strong and her smile shining until the end.

Her hospice experience allowed her dignity and comfort until her death. Practicing hospice has been a teacher to me. I have learned some of life’s greatest wisdom by observing this type of bravery.

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Demyst Hosp

As a Hospice and Palliative Care phys providing end-of-life care day in and da home and cry each day from seeing d “end-of-life care is highly satisfyin

tifying pice

sician, many people have asked me if ay out is excruciatingly sad. Do I come death? “Quite the opposite” I respond, ng and morally rewarding work!”

Recently, the young wife of a Head and Neck cancer patient I saw at Transitions did not understand from a spiritual perspective why we were not recommending IV fluids in her husband’s head and neck cancer.

I was able to sit down with her, over some ginger tea, and explain his cancer and how IV fluids could detract from comfort now since his lungs were fluid overloaded. She shared her Hindu spirituality with me and stated that if only she had done more reiki and if he had more love, this would not have happened.

She relayed 7 years of anticipatory grief that day with me. Slowly, I allowed her to speak and guided her with questions and gently educated her on how we could accomplish her goal, but differently than she thought, medically. We spoke about self care, boundaries, spirituality, and how she would be the lead of the home after he was gone. She became receptive after several physicians tried to talk to her in the hospital. With no agenda, I just met her where she was and she called me the next day to transition him to hospice. She understood and trusted that their goals were my goals. I even added medications, in fact, that afforded him a comfortable death. To her this meant if he went in peace, his next journey would be of peace.

A patient of mine from 2013 who was a writer Madeline L’Engle, wrote “until my journey led me to hospice, I didn’t understand how valuable they are. I misunderstood what they did and when I mistakenly thought that they were called end of life and didn’t know about the quality of life that is given to the patient and support for the family much earlier than that! I had a team consisting of a specialized team of doctors, nurses, and a chaplain who truly made my situation ‘quality’! They are people who not only care about me and my family’s needs, but share themselves. They are a community of care.

The ‘quality of life’ is not only about medical solutions to situations that the disease causes, but planners about what to do when this happens and we do this when this no longer works. It is about keeping me comfortable and doing what I am able, as long as I can.

They are walking with me and my family and that is a tremendous gift, to know that you are not alone! Help me spread the word about hospice, for life is precious!”

Hospice is a misnomer, a gift with a bad wrapping job, because it is so often misconstrued. When we finally understand that it’s so much more than death, but in fact about ensuring that patients live the type of life they want, for the rest of the time they have on this earth, we begin to realize what hospice really is -- it’s about living.

To learn more about Transitions or to schedule a meeting with a Regional Hospice Coordinator, visit www.transitionshospice.com or call 877.726.6494.

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CMSA Chicago would like to give back to our members and guests. To show our gratitude for your continued support during these difficult times we are discounting the cost of our 2021 Annual conference for you.

Early Bird Deadline: Monday March 22nd

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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 postdischarge 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 between the different subacute skilled facilities and poor-quality home care agencies and can guide

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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.

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

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