Elevating Patient Care: Insights from Bonnie Geld’s Presentation at Wellsky’s CareForum 2023

Lindsay Tsai
Case Manager with Patient_Image

Unveiling the Power of Case Management for Improved Patient Flow and Outcomes

The Center for Case Management is a woman-owned company that provides comprehensive assessments of the care management department and its related functions. President, Bonnie Geld, took the stage at the 2023 Wellsky CareForum to share key issues addressed by case management and best practices for case management teams to increase their influence to ultimately improve outcomes for the patients in their care. Here, we delve into the key insights shared during the presentation.

1. The Mission of Case Management

Case management’s mission is to manage complex patients through the episode of care to the community of care. This involves orchestrating patient flow, optimizing capacity, and curbing preventable readmissions. The goal of a case manager is to assess and advocate for these patients, while aligning with an interdisciplinary team to address the patient’s clinical, psychosocial, and financial needs.

2. The Three Pillars of Effective Case Management

In the realm of managing complex patients, case management takes on three pivotal roles:

  1. Early Identification of Complex Cases: The cornerstone of successful case management lies in the early identification of complex cases. Continuous screening throughout a patient’s stay is key to spotting both obvious and subtle complexities. More obvious cases may include patients with multiple comorbidities, while other cases grow more complex throughout the stay, such as patients with anxiety and depression affecting a timely and safe discharge plan. An astute case manager discerns the nuances, identifying cases that require support, even when the complexities are not immediately evident.
  2. Supporting patient progress across the episodes of care: For complex patients, recovery is not a straight line, so care management should look to move them from A to Z efficiently, not just eventually. This includes team alignment to the care plan. As clinicians rotate through shifts, it falls upon the case management team to maintain the narrative thread, ensuring everyone is aligned on crucial milestones, the ideal discharge date, the ultimate destination, and strategies to enhance the patient’s quality of life.
  3. Championing Sustainable Transitions: At the nexus of care, case management addresses every facet of an individual’s well-being, incorporating equity, diversity, inclusion, and advocacy into the patient journey. Registered nurse case managers meticulously review clinical care plans and address health literacy for patients and their families, while social workers tackle psychosocial needs by navigating the intricate web of social determinants of health. Utilization reviews ensure seamless access by aligning financial access with benefit packages and care plans.

3. The Synergy of Technology and Case Management:

The value of technology is to complement and accelerate the existing skills of case management. Regardless of the platform or technology selected, the solutions should increase alignment to the care plan, support bidirectional communication to care settings outside the current facility, accelerate referral management, effectively share relevant patient information, and ultimately amplify the influence case management has on the patient outcome. Building dashboards with key performance indicators is a great place to start.

In Conclusion

Case management stands as the lynchpin that comprehensively addresses the clinical, psychosocial, and financial needs of patients. These dedicated professionals are the lateral leaders on the frontline of care, working tirelessly to ensure every patient’s journey is met with expertise, compassion, and precision. As Bonnie Geld aptly highlighted, their role is pivotal in elevating patient care and reshaping the future of healthcare delivery.