Case Management Focus: Goals — Your Road Map to Success

Setting goals is a core competency workers' compensation case managers apply to every case they work. Setting and achieving those goals allows the case manager to prove their value to the injured worker, the employer, the healthcare team, and the organization they work.

Goal setting takes place after the initial assessment. To prepare for the assessment, take time to review the file notes, the date and type of injury, and what has happened since the first report of injury. Take time to meet the injured worker, the treating physician, the treatment team, and the employer. Find out what work the injured worker does and what necessary skills and body functions are needed to do the job. Gathering information from all parties gives the WC case manager a picture of the case and the resources required to reach the goals. Keep in mind that the IW should be part of setting goals as this is their care plan. Including them will also help with buy-in.

Goals help you meet milestones. They should be:

• Specific
• Measurable
• Attainable
• Realistic
• Time-bound

Once you set your goals, you can start the plan of care. The care plan is reviewed at each meeting with the Injured Worker and all other stakeholders to ensure all agree. Some goals may be short-term, while others may be long-term. Next, look at how you will implement the plan and the resources needed to help the plan work.

It is essential to closely monitor the plan to ensure it is meeting the injured worker's needs and that they are making progress. Keep all lines of communication open with everyone involved. Doing so helps you build trust and recognize and address barriers so they can be identified and addressed. Be proactive and try to avoid setbacks. If they occur, you can minimize them by staying on top of the case.

Review the goals with the injured worker and the treatment team so new goals can be set as you meet or rework existing goals. Once you achieve goals, celebrate your successes and the team that made them happen!

With each report, discuss your goals and note if they are still important. If you have met them, note that. If you still need to meet them, what is the plan to reach the necessary goals?

I asked a few of my colleagues how they set goals.

One shared: I set goals based on the needs of the injured worker and their anticipated recovery with their physical description of their job duties in mind. I also consider their avocations and non-work goals.

Another said: I break my goals into the following area:

• Medical goals—right provider for injury/illness & personality, nonsurgical/surgical goals, MMI w/least functional disability.
• RTW goals—modification of job/early RTW; RTW full duty within their job role or minimal modifications once MMI
• Educational goals---educate IW/family in the healthcare system, educate employer/adjusters (managers/supervisors) on injury/illness process through the healthcare system & expectations.

In each report, make a case for your involvement and discuss steps you are taking to reach medical, work, and psychosocial goals. Using these goals will help you show your value!

When you close a case, evaluate how you did, what you accomplished, and what you learned. Take time to document the resources you used and how they worked out and store them so you can use them again or not and the reason.

A worker's comp case is not a marathon but a thoughtful process. Goals will guide you and keep you, the injured worker, and the other stakeholders focused and on track. Note in your report the goals you and the injured worker attained and the timeline it took to achieve these goals. Let me know your process for goal setting. Please email me at allewellyn48@gmail.com, and I can include them in a future column.

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