1. Powell, Suzanne K. MBA, RN, CCM, CPHQ
  2. Carr, Dana D. MPH, MS, RN-BC, CCM

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Management is doing things right; leadership is doing the right things. In today's healthcare marketplace, the words of Peter F. Drucker could not be truer. Increasingly, we see case managers actively assuming leadership roles in hospitals and other healthcare settings. However, in truth, case managers consistently approach their responsibilities in leadership mode.


Each day, case managers don many hats as they address the individual healthcare needs of the patients they serve: facilitator, communicator, advocate, change agent, educator, mentor, and leader. In certain circumstances, they partake in these roles simultaneously. But to engage effectively in each role, case managers must demonstrate leadership in every aspect of their practice.


If management is doing things right and leadership is doing the right things, then case managers need to shoot for "doing the right things, right!!" (which is managing and leading). Exactly what are we talking about? To manage means to bring about, to accomplish, to have charge of or responsibility for, and to conduct. As case managers, managing care encompasses all the actions that we do when we coordinate and manage every aspect of the patient's care. What we do is so pervasive that it can barely be listed. For starters, case managers are knowledgeable professionals who multitask in a myriad of ways. They assimilate and process data, manage care along a critical path, and achieve cost and quality outcomes; all of which add value to the healthcare organizations in which they serve.


However, to be effective in the way we manage, we must also lead. Leading is influencing, guiding in a direction, course, action, or opinion. The case manager not only consistently and successfully enacts the roles and functions above but also assists in unifying the work of doctors, nurses, socials workers, and other healthcare team members. This is done through influencing, guiding, adding to the pool of knowledge, and promoting a collaborative process.


This is not always easy. As coordinators of care with responsibility for fiscal oversight, daily case managers are challenged to establish, foster, and maintain professional relationships at every point of the care continuum. A principal role in play is that of being an effective leader-and a key element of successful leadership is the ability to build and sustain relationships.


As the healthcare paradigm continues to shift, challenges to the leadership role are on the rise. However, effective leadership is about facing challenges and problems associated with them, dissecting and evaluating their impact, and improvising/ adopting strategies to solve them. As an influential member of the multidisciplinary team, the case manager has the ability to guide and impact the care delivery process. Singularly, but often in plural with the team, case managers face challenges and solve problems daily.


Whether you are a nurse case manager, social work case manager, disability case manager, or case manager with expertise in another health-related discipline, the goals of patient care are mutual-to lead the team, while maintaining a course toward the attainment of positive patient outcomes.


Lest you say, "but I am no leader," I challenge you that leadership is within you, waiting for an opportunity to surface. Niccolo Paganini (1782-1840) was one of the most celebrated violin virtuosi of his time. There is a story in which Paganini was about to perform before a standing-room-only opera house. As he walked on the stage, he realized that, rather than his treasured violin, he had in his hands a strange instrument. Panic-stricken, but realizing he had no other choice but to play with all he possessed, he gave a stellar performance.


As he went back to his dressing room to a standing ovation and was praised for a superlative performance, he replied, "Today, I learned the most important lesson of my entire career. Before today I thought the music was in the violin; today I learned that the music is in me."


Leadership roles can be daunting-especially when one must adhere to rules and regulations that span ethical, legal, and advocacy principles. But if you remember one thing, remember that the music-or the right thing to do-is always within you. THAT is leadership-the wisdom to know and do the right things.


The leader that resides within is made manifest each time we mentor and motivate others to act; new nurses, therapists, physicians, and many of our other healthcare colleagues are positively impacted by the actions of case managers at work. As we advance our ability and our voice, we have the distinct opportunity to influence the defined leaders of healthcare, and in doing so, case managers themselves exert their leadership ability.


Perhaps 5 or more years ago, as I was flying back from another stimulating Case Management Society of America annual conference, I mused that perhaps we should change our name from "case managers" to "case leaders." After watching our evolution and growth during the subsequent years, I am even more certain that-whatever we call ourselves-we are healthcare leaders.


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Mission Statement:Professional Case Management is a peer-reviewed, progressive journal that crosses all case management settings. PCM uses evidenced-based articles to foster the exchange of ideas, elevate the standard of practice, and improve the quality of patient care.