The Benefits of Belonging to a Professional Organization When Disaster Strikes

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This article shows the value of belonging to professional organizations and the connections made through networking. The members and the past presidents of CMSA are resources you can tap into for advice, mentoring and referrals and are key people when you, a member of your family or a friend are suddenly thrust into the complex healthcare system.

IT BEGINS WITH ‘THE CALL’

This is the call you dread to get in the middle of your day…a frantic, desperate call pleading for your help. My closest friend was struck by an SUV while walking her dogs in southern Florida, sustaining a massive brain bleed. We had just been on the phone planning our next hiking trip to Portugal, and now with a heavy heart I realized I would start to work on a new plan for my dear friend. As a certified case manager in Illinois, I knew she would benefit from having a case manager to help streamline communication as the team coordinated her care to ensure the best outcome. I reached out to the case management department of the community hospital where she was admitted but was dismayed and, frankly, upset at the response I got from the professionals I talked to.

I quickly realized exactly what I needed to do to get help. I put in a call to the president of my local Case Management Society of American Chapter, CMSA Chicago. Colleen Morley immediately contacted Anne Llewelyn, nurse advocate, who is a past president of CMSA and the current president of the South Florida Case Management Network, to see if she could help me. Anne responded right away, and Colleen connected us both to see what we could do to address my friend’s needs.

Anne was a wealth of knowledge, experienced and informative. Together, we talked about how we would move forward to learn how my friend was doing, what the plan of care was and try to find the resources that would help the patient find the right level of care to meet her needs. Anne sent me her consent form and asked to have the patient’s family review and sign the form if they wanted us to help. We actually had a call with the patient’s daughter to explain what we wanted to do and how it could help her and the patient navigate the system. The daughter has her own healthcare challenges, and the stress of this ordeal was taking a toll on her condition.

Anne helped me research facilities I had never heard of since I am a hospital-based case manager in Illinois, not familiar with Floridian facilities. Together we developed with the healthcare team at the hospital to design a discharge plan utilizing our case management skills to ensure the patient could transfer when ready and get the best care to address her traumatic brain injury. We worked hard to communicate with the hospital case manager but ran into resistance. We both could not understand why we met resistance; were we not colleagues? It was disappointing. We spoke to the various physicians and the nurses on the unit to gain information on the plan.

CHALLENGES

I had to intervene at one point, as my friend’s “case manager” decided to transfer her to a lower level of care, a skilled nursing facility, based solely on her age! When I asked about the COVID situation in these facilities, she stated she had no idea and would get back to me, and I never heard back from her. Without hesitation, I asked for a multidisciplinary team meeting with medical representation to discuss the treatment plan and discharge needs. I spoke up during the meeting to advocate sending her to an LTAC as the most appropriate level of care, not a skilled nursing facility as the case manager was representing. Prior to the accident, my friend was active, alert and very independent. She needed acute rehabilitation, not a skilled care facility.

During her hospitalization, we thought we might have to transfer my friend to northern Florida; Anne put me in touch with a case manager from the area who knew the area and the resources. This person helped me identify facilities that would meet my friend’s complex needs. We felt the next step should be an acute brain rehabilitation program, and again with Anne’s assistance, I researched the various facilities to see if they were in the patient’s insurance network. The patient was transferred from the hospital to an acute brain injury program for intense cognitive therapy.

THE OUTCOME

The facility where the patient was transferred did a good job. The case management team was excellent, and the patient is making progress. The family and I were kept up to date, and all were satisfied with the patient’s progress.

We have a good plan going forward as we plan next steps to meet my friend’s long-term needs. Her family is engaged and grateful for the help.

This situation made me realize the value of my professional organization, the Case Management Society of America. With one call to a colleague in my area, I was able to meet a case manager in South Florida who knew the resources and the people to connect me to who could help all involved.

I understand what was happening and feel comfortable as we navigate the complex and fragmented healthcare system in an organized and professional manner.

My next step is to write a letter to the director of case management at the hospital where my friend originally taken. I want to talk to the leadership to share my concerns and help them realized how we could have collaborated for the good of the patient when family members of complex patients are out of town. I want to use the experience as a learning experience and one that could help their team improve.

The patient is doing well, and the family is optimistic. It was a challenging case, personally and professionally, and with the collaboration of many people, we had a good outcome!

Wendy Jaffe, RN, MSN, ACM, is a patient care coordinator at the University of Illinois Hospital & Health Sciences System in Chicago. She received her BSN from Lewis University and her MSN at Elmhurst University. She has worked a variety of settings and has been an active member of the Case Management Society of America Chicago chapter for 23 years. You can reach Wendy by email at .

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