Case Management Focus: What are Your Superpowers?

The Case Management Society of America Case Management recently updated the Case Management Standards of Practice. In reviewing them, I came across one of the guiding principles that caught my eye. It was that case managers facilitate clients' self-determination and self-management through the tenets of advocacy, shared and informed decision-making, counseling, and health education whenever possible.

As I reflect on this principle, I thought about my practice as a workers compensation case manager and how I interact with injured workers, their family, the employer, the adjustor, and medical team. I found these principles were the strengths I bring to help each member of the team understand the situation, the barriers and the resources needed.  

Here are some examples of how I meet this guiding principle. 

I attend doctor's appointments with the injured worker in person. Before we see the doctor, we review what we want to discuss so we have talking points when we meet the doctor. Going through this exercise helps us both focus and prepare for the meeting. 

I invite the injured workers caregiver (or the central contact person) to doctors' appointments. If they can attend, we all prepare for the meeting as noted above. If no one can attend, I ask if they want me to call them when we meet with the doctor and patch them in so they can ask any questions or bring up concerns they have. Doing this helps them to hear firsthand what the doctor is planning and have input into the plan. Having all parties to be on the same page helps to keep all informed and to streamline communications. 

So, if I cannot attend an injured workers’ appointment, I ask the patient to patch me in on the call so I can be present once the doctor is in the room. I also email any questions or issues I want to remind the doctor to cover at the appointment, so we get answers during the visit. 

When calling a provider, an equipment company, or a home care agency, I try to have the injured worker on the call with me. This allows them to hear my questions and the provider's answers. It empowers the patient when they are on their own to ask questions and clarify their information.  

I hold team meetings with the various providers on complex cases. This allows us to address current issues and things that we want to address/prevent. It keeps the team focused on where we are and where we want to go. 

I talk to the patient and the family to set realistic expectations. I try to explain how the system works and help them understand that even though it is frustrating, working through processes in an organized manner helps them to get the resources to meet their needs.

I let the patient vent and share frustrations. I try to show empathy and help them understand that it is not them personally – but a system that is in place that is complex.

I explore alternatives when the insurance company cannot approve a service or resource. I work to find community resources to meet the injured workers needs as best I can. 

To me, the most frustrating thing an injured workers experiences when thrust into a complex healthcare system is the loss of control of their lives. I try to give them control back by having them be active participants in their care. I help them regain control by learning how to self-advocate for what they need.  

What are your superpowers? Make a note in the comment section, as to how you meet the needs of your clients as a workers’ compensation case manager. 

Resources: 

Case Management Society of America Standards of Practice for Case Managers. If you work as a case manager, these are the Standards that all must adhere to in our practice. Download your copy at www.cmsa.org/sop 

Stories from a Nurse Advocate: This was a special report that I complied to share stories I have written to share my experiences and learnings from my practice. Feel free to download the PDF at https://anne-llewellyn.s3.amazonaws.com/Anne+Personal/Storytelling+From+a+Nurse+Advocate/PDF+-+Storytelling+from+a+Nurse+Advocate.pdf 

Share This Article: