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Nurse Case Managers Follow Up for Good Outcomes

Nursing Spectrum—September 13, 2010

Advocating for patients, coordinating care, finding resources, educating patients and family members, and facilitating services — it’s all part of RN case managers’ daily duties.

Case managers enjoy helping guide patients through the continuum of care and getting them the services they need, adds Rachelle Schwartz, RN, MA, CCM, director of case management at Hospital for Special Surgery in New York.

“They ensure the patient is receiving the appropriate care at the appropriate level, and they are liaisons with the rest of the team,” Schwartz says. With an increasingly older patient population and with more patients covered by managed care plans, she reports a greater demand for hospital case managers.

Case managers work collaboratively with the insurers, the interdisciplinary care team at the hospital and staff members at the receiving agencies, Schwartz says. Case managers help patients understand their health-insurance benefits, which will affect the plan of care. About 80% of patients at Hospital for Special Surgery require assistance with discharge planning.

“You have to juggle so many things — what the patient needs, the benefits and the resources in the community they are entitled to,” Schwartz says. “That can be challenging and very rewarding.”

Caseloads vary from 12 to 15 patients at Nyack to between 25 and 30 patients at the Hospital for Special Surgery.
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