I suspect there are many of you experiencing a roller coaster ride of professional and emotional reactions to our world, your family and careers. Consider the COVID-19 pandemic: There have been extraordinary changes to our life patterns as we prevent, mitigate and navigate the healthcare environment with additional layers of complexity due to all of the above. What is not receiving enough public attention is the fact that other illnesses and diseases are still present. Injuries continue to occur as a function of living, playing and working. Many people need surgeries, and others desire elective procedures to improve their quality of life. This gumbo of scenarios leaves our patients confused about choices, and providers are challenged with what to tackle first. How can case managers bring calm to chaos?
EMBRACE. The roller coaster analogy is a good illustration of how case managers may tackle complex challenges head on. The minute we make the decision to take the ride, strap in, check our surroundings for any loose ends, make eye contact with our riding partner to inspire confidence, then settle in, we have embraced the knowledge that we will be turning, twisting, circling, ascending and descending in our journey.
ANTICIPATE. The first ascension gives us time to prepare mentally and just maybe plan with our partner how we will react during certain parts of the ride. As case managers, we reflect on prior cases that were similar, consult with colleagues and interdisciplinary professionals, host care meetings to collect information, then develop a plan and set that plan in motion as we address each barrier, standard, resource or situation along the way. As we reach the top of that first coaster climb, we have our plan, we have engaged the system and we are ready to see where that takes us. This is where different roller coaster designs come into play.
INNOVATE. One roller coaster design may have a short initial drop, then a few feet of smooth riding, then a jerk into multiple twists, turns, flips and spins. Another design may drop into a smooth and exhilarating downhill ride for several seconds before the chaotic turning, circling, twisting, upside-down spinning kicks in. Either design is filled with unknowns, unexpected movement, and a false sense of security that leaves us feeling fear, satisfaction, excitement and anxiety all at the same time or within a few seconds. Managing the care of patients in the COVID-19 environment at a time of resource constraints, reduced opportunities for transitions, in a fatigued healthcare system that is stressed financially and systemically – and where patient safety is at its highest risk – makes case management even more dynamic and complicated. Case managers are fulfilling new roles and upskilling their practice to accommodate unique twists and turns present in today’s hospital, ambulatory and community care environments.
CELEBRATE. Continuing with the roller coaster analogy, the ride typically begins its conclusion with one final climb to a high point, and then a death-defying drop that evokes a sense of accomplishment that you have made it to the end as the remainder of the ride will be smooth sailing into a steady state of contentment at the terminal. That last ascension to the top represents a culmination of lessons learned, patient responses to treatment and care planning, resources that required tremendous effort to secure are now in place and the interventions are now reset to achieve the ultimate outcome. The case manager is now paused at the top, having mastered the previous chaos and ready to descend toward achieved outcomes and finally, case closure. That last drop is gratifying, affirming and celebratory for the case manager, patient and family.
With this analogy, every patient or client presents a different care journey, and most are represented by twisting, upside-downs, starts and stops scenarios that require a skilled, professional case manager to turn chaos into smooth, coordinated care that results in a steady state of self-management. Case managers create solutions by embracing the situation, anticipating the complexities and innovating results.
I intend to use those same attributes for CMSA as our association embraces the complexities of the healthcare environment during this pandemic, anticipates what and how we provide support for our members and drives innovative solutions for the profession. My ask of you is to be open to serving on a committee or as an advisor or lending your talents to lift CMSA to new peaks on our roller coaster of member association engagement and leadership. Embrace, Anticipate, Innovate…We can do this!
, MSN, BSN, NE-BC, CCM, is president of Case Management Society of America 2020. Recently retired as an Air Force colonel, she is chief executive officer, Care Associates Consulting and frequently requested to deliver presentations, editorials and training on various case management and leadership topics. Melanie is a certified professional case manager and nurse executive, and possesses master’s degrees in nursing case management and military strategic studies.
