Case Managers Take Extra Steps in Tough Economy

As the economy has tightened, patients’ discharge needs have become increasingly complex. At the same time, Medicaid guidelines for home health care have changed and private insurance companies continue to focus on timely discharge. While this environment is stressing case management staff at most hospitals, Memorial Hospital Pembroke’s Clinical Case Management (CCM) team has risen to the challenge.

“We start by doing very in-depth assessments with patients and their caregivers,” explained Susan Levine, R.N., and Director, Clinical Case Management, who heads a six-person team with a total of 77 years of service in the field. “Experience really makes a difference here because some of our sickest patients have very limited means. So, we have to determine exactly what their needs will be at the time of discharge.”

The Memorial Hospital Pembroke Clinical Case Management Team includes (front row l-r) Linda Kirkeberg, R.N.; Jennifer Groves, R.N.; Debbie Hand, LCSW; Marise Christophe, R.N.; Carolyn Timmons, R.N.; Louise McLune R.N., Sandra Jaime, Secretary; (back row l-r) Susan Levine, R.N.; and Deloris Thompson, R.N.

The team feels that its shared expertise makes a difference every day on the job. “We’re working from something we’ve already done but now we have to be very creative with the limited resources available in the community,” said Delores Thompson, R.N., and Clinical Case Manager. Also on the Memorial Hospital Pembroke CCM team are Carolyn Timmons, R.N.; Marise Christophe, R.N.; Linda Kirkeberg, R.N.; Louise McLune; and Jennifer Groves, R.N.

Thompson pointed out that daily rounding with staff hospitalists has helped the team better understand patients’ needs. “Teamwork within the hospital staff and among ourselves enables us to provide better service to our patients,” she said. Work often continues over lunch as the CCMs share strategies for assisting patients and securing much needed services.

Patient satisfaction scores for the case management team are excellent, demonstrating that the group is achieving its goals. Thompson explained, “Our ultimate goal is a safe discharge for every patient—one where he or she is getting exactly the care needed to recover properly following hospitalization.”