Across all practice settings and years of experience in case management, “a lack of understanding and standardization of the role of case managers” was at the core of and central to most other issues.
STAFFING and WORKLOAD Throughout the focus groups, I worked to tease apart the issues around staffing and workforce. In general, across all practice settings and all levels of experience this issue came across as: 1. 2. 3. 4. 5. 6. 7.
Not enough staff, or insufficient staff Lack of qualified staff Not enough people applying with the right qualifications Enough people with clinical skills, but not enough with critical thinking skills HR departments that don’t know how to hire for case management positions Not enough people applying whether qualified or not The correct patient to CM ratio
Staffing frequently becomes an issue when non-case management duties are delegated to the case management department. This seemed to be most prevalent in acute care. For example, many case managers are heavily involved in the accreditation process, while maintaining a full caseload. Although they understand the importance of participating in the process to ensure understanding of the standards related to accreditation, it I have trouble filling spots, because I represents a burdensome addition to an already full workload, and could can’t find qualified applicants…so, it “We adopted the CMSA standards compromise quality case management performance and/or patient comes to not having enough staff, and worked with our community but not because I don’t have enough satisfaction. Participants frequently identified delegation of a variety of college system within the state to applicants. I have the FTEs, but end administrative tasks to the case management department in addition to develop a case management up interviewing and interviewing. their patient caseload. Work comp was the only area that did not seem to assistant program. In acute Some people really don’t wantcare to settings you pair a nurse’s aide with be struggling with this issue…Citing, however, the WC caseload does ebb and work this hard the RN. If you have the title of case flow, and is more likely to be unpredictable. As we discussed this issue, I explored the degree to which participants used the CMSA Standards of Practice. Participants unanimously felt that the SOP was a great tool and guideline for them individually. However, in its current form, the SOP is of no real value in working with their employers. Participants want their employers to understand the SOP and want to use it to explain to their employer what case managers should and should not be
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manager then you’re licensed either as a social worker, or as a registered nurse. And if you’re not a case manager you are a case manager assistant. It’s the same rule of delegation we had in the hospital. I knew what a nurse’s aide could do for me, as a nurse. There is a lot that they can take off which allows us to be more competitive in our staffing.”