1. Owen, Mindy RN, CRRN, CCM

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So often in this column I am asking questions ... and as I ask those questions, they are directed at myself and challenging me to evaluate how I can continue to help make the practice of case management better, more focused, more patient centered, and more understood. I am always hopeful that I am not alone in asking the questions and hope you will continue to share your questions and answers with me through this column. But as we see the complexities of healthcare growing, it remains a challenge for all of us to continue to be compassionate professionals, juggling a diverse, multifaceted caseload that is filled with individuals needing our undivided attention. In my last column, I said we have a big role to play and an opportunity to promote our professional commitment to improve the landscape of healthcare. What can we do at this critical time, as case management professionals?


I cannot leave that question hanging, without at least reflecting on what I believe we, as a profession, and CMSA, as an organization, have contributed over the last 20 years.


Today we are celebrating the 20-year anniversary of our professional organization. When I think back over the last 20 years and what we hoped to accomplish by establishing this organization for case managers, we are able to say that through collaboration, focus, and commitment we have been engaged in the delivery of healthcare; and we continue to strive to have our voice heard on critical issues, all the while maintaining our role as patient advocate, facilitator, professional, and confidant.


Twenty years ago, we could not foresee the challenges that we would all be facing today:


* Drastic reduction in complex healthcare reimbursement,


* Patient resources being reduced/eliminated/or unavailable,


* The role of technology within the practice of case management,


* Increasing fragmentation of healthcare delivery,


* Case management more closely aligned with financial outcomes and management, and


* The impact of healthcare legislation on our practice.



And the list continues to grow, as I have just named a few of the many challenges we face today.


So let us take this opportunity to look back at some examples of what we have in place as resources and tools to help us in our role:


* A strong definition of case management-1991-revised to reflect the evolution of the practice (2007),


* A consumer definition of case management (2005),


* Standards of Practice-1995-revised 2002, revised to reflect the evolution of the practice (2010),


* Case Management Adherence Guidelines,


* The Case Management Model Care Act (2009),


* Avenues to pursue further education and certification as a professional (1993),


* The Code of Conduct,


* The CMSA Core Curriculum 2001 (revised 2008), and


* Transition of Care Web site and resource.



These tools and resources have been designed, developed, and implemented by professionals who have volunteered their time, expertise, and energy to enhance the case management practice. I believe that these tools are a strong foundational base and one on which to build for the future of case management. And that brings us to the next 20 years.


What does the future look like? I believe that within the next 20 years we will see more opportunities within the practice of case management than we see today.


Case managers will be in key positions within acute care and transition management not only to facilitate the correct "care plan" but also to articulate the clinical, financial, and quality implications of its implementation at even a higher and more detailed level than today.


Case managers will be looked to for leadership in patient-consumer education, resource development, and financial implications of the care planning process. There will be more reliance on the unique interventions that case managers have put in their "tool kit."


Case managers will continue to rely on technology as a tool to support the practice, yet not be reliant on the technology at the expense of patient-physician-case manager interaction and collaboration. Just as we see and hear that studies are showing that a reduction in face-to-face, voice-to-voice communication has been to the detriment of overall collaboration, I believe case managers will continue to lead within healthcare and encourage a strong collaborative base.


Case management is growing up!! We are still being asked, "What is a case manager?" But as the role has evolved, the answer has become clearer... a healthcare professional who cares about the individuals he or she serves, who cares about building a respected practice, and who will never stop making it better.


Today ... Let us celebrate our accomplishments as case managers and be proud of who we are ....


Tomorrow ... Let us get back to what we do best, use the tools we have, build on them, and make healthcare better for those we serve, one patient at a time.