Penn Highlands: Case managers play an important role in healthcare
DUBOIS — Doctors, nurses and physical therapists are common sights in a hospital. But did you know that case managers also work in hospitals and other healthcare settings to assist patients and their families?
“Case managers serve as patient advocates, helping them understand their medical conditions and offering guidance on available resources that address the emotional, financial and social challenges accompanying a diagnosis,” said Trisha Salome, PT, DPT, service line director of case management and CDI at Penn Highlands Healthcare.
Case managers collaborate with healthcare providers, discharge coordinators and administrative staff to help ensure patients receive the care and resources they need. They are often employed in hospitals, home health services, nursing care facilities, outpatient care centers and other settings.
“The primary role of case managers is to evaluate the patient’s needs to help them achieve the best outcomes. They work with the patient, physicians, nurses and family members in order to understand the patient’s unique case history,” said Trisha.
Other responsibilities of case managers differ, but common duties may include:
• Assessing a patient’s physical and mental wellness needs and abilities to develop individualized care plans
• Working with the patient, family and the healthcare team to put the plans in place
• Patient counseling and education
• Recording and evaluating the patient’s progress and adjusting services as needed
• Discharge planning and follow-up
• Patient advocacy
Patient screening: intake
Individuals with highrisk factors, mental health conditions or other challenges typically undergo an initial evaluation conducted by a case manager. This evaluation encompasses a thorough examination of the patient’s social, emotional, environmental, medical and financial requirements. The findings are then shared with the other members of the patient’s healthcare team to help guide the treatment approach and overall prognosis.
Patient counseling and education:
Case managers also support patients and their families in managing the emotional and social aspects of illness and treatment. They provide education about entitlements, community resources and health insurance coverage. They may also facilitate support group sessions and offer individual counseling services.
Recording and evaluating progress:
Case managers are often responsible for handling the paperwork associated with each of their patients. This may include monitoring, evaluating and documenting patient progress during treatment to ensure that recovery proceeds as anticipated.
Discharge planning:
Prior to discharging a patient from a hospital or a healthcare setting, the case manager ensures that the necessary services are arranged and the patient receives adequate care at home or at the next level of care. This may involve organizing resources for medication and medical equipment expenses, connecting patients with social service providers and coordinating home healthcare services.
Patient advocacy:
Above all, a case manager serves as a patient advocate, prioritizing the patient’s needs and goals. It is their duty to ensure that the patient’s preferences are respected by the rest of the healthcare team. They advocate for patients by facilitating communication, organizing health insurance coverage and championing patients’ rights throughout.
Case managers are there for you while you are in the hospital and when you return home. They not only help plan and monitor inpatient services, they make the discharge process smoother.