Population health management. This approach to care is rapidly shifting from theory into practice. For many reasons, both payers and providers are now interested in identifying and stratifying populations that can benefit from quality initiatives that are designed to meet the specific needs of the group. Because PHM is a comprehensive approach to health, case managers will be needed to coordinate an entire spectrum of services aimed at correcting behavioral, economic, and environmental barriers to care.
- Diversity and cultural awareness. Case managers working with specific populations must understand their fundamental communication and cultural differences. For example, the Joint Commission lists five competencies needed to provide culturally competent care within the Hispanic community. It states that to build a trusting relationship with a Hispanic patient, healthcare workers must be able to assess the individual’s language abilities, family hierarchy, perceptions of health, environment, and available resources. Case managers may also need to leverage key community partnerships to reach underserved patients.
- Transitional care management. Because of Medicare’s readmissions reduction program, case managers working in hospitals are being called upon to design and implement strategies for more effective discharge planning and transitional care coordination. This involves a comprehensive assessment of individual patient needs and a formal process for follow-up, with an emphasis on evidence-based strategies. It has become such an important focus that the Case Management Society of America (CMSA) has created a new certification focused on skills needed to manage transitions of care.
- Patient engagement initiatives. In certain settings, case managers may need enhanced patient education skills, in order to promote healthy behaviors and the self-management of chronic conditions. They’ll need to be able to assess the health literacy and resources of an individual or a patient population, and implement targeted interventions that can boost patient engagement. Our evolving healthcare system can no longer view all patients through the same lens.
- End of life planning. Advances in medicine and technology and conflicting societal values have made end-of-life decisions increasingly complex. Case managers in certain settings may need a thorough understanding of the choices available to patients and their families – including hospice, palliative care, and life support options. They have to be familiar with evidence-based standards for managing terminal illness, ethical considerations, and legal paperwork like advance directives. End-of-life planning is now emerging as a case management specialty, with defined standards.
- New technologies. Emerging evidence shows that elderly or chronically ill patients may be able to remain at home, enjoy a higher quality of life, and realize better outcomes through technologies that include remote monitoring, telemedicine, and smartphone apps that help with self-management. Strategic use of technology has been demonstrated to reduce readmissions for patients with heart failure and to increase medication compliance. Yet there are also ethical, regulatory, and privacy issues to consider. And there’s the fact that, according to CMSA, the average age of case managers today is over 50 – will they be able to keep up with technological strategies?
The bottom line is this: A case manager who is empowered by knowledge and top-notch skills can, in turn, empower her patients. If you’re an RN with an interest in working closely with patients, their families, and their care teams to improve quality of care and outcomes, you might consider a career in case management. The perfect way to build the skills you need is through American Sentinel’s online RN-to-MSN program with a specialization in case management. American Sentinel University is an innovative, accredited provider of online nursing degrees that can empower you with knowledge and help you reach your career goals.