As a growing body of research continues to point to the increasing impact of external factors on people’s health, the healthcare industry is also evolving in the way it delivers care.1 Case managers stand at the forefront of this evolution.
Case managers understand how often-overlooked factors such as hunger, isolation, and other social determinants of health affect people’s overall well-being. They know that the most effective way to make a difference is to take important factors into account when working with the people they serve.
In the past, case managers have often been quiet caretakers; their voices have not been part of important conversations in the healthcare ecosystem. It is time to extend their influence and have their voices heard so they can advocate more forcefully and lead needed change in our healthcare system.
A key foundational step toward amplifying case managers’ voices so they can be full partners in leading healthcare change is to establish a more connected professional community. When case managers – or care managers, as we refer to them at Humana – share their experiences with one another and with leaders in their organizations, their network grows stronger, the care they provide becomes more effective, and their influence on people’s health is magnified.
At Humana, a company most known for the Medicare health plans we provide across the country, we have approximately 10,000 clinicians on staff – close to one-quarter of our total number of employees. Many of these clinicians – nurses, nurse practitioners, social workers, and other social services professionals – serve in a care manager capacity, as well as other leadership and strategic roles essential in advancing our mission of improving lives.
Importantly, we are leveraging the expertise of these clinicians to help us drive change. We have created a clinical community of practice to bring the voice of care managers, regardless of their specific discipline, to the table.
This means we listen to their needs, rely on their expertise, and put their ideas into practice. We are constantly looking for new strategies that address the behind-the-scenes needs of care managers and empower them to feel and do their best, personally as well as professionally.
Through leadership development, enhancing contemporary clinical skills, and peer-to-peer interaction and recognition, we have found clinical communities of practice to be an effective way to increase care managers’ sense of belonging. This, in turn, positions them to influence the health of the communities they serve and strengthens their impact through mentoring and leadership opportunities within the professional practice environment. When clinicians feel valued, they are more engaged – with more of a stake not only in their workplace but in the people they serve as well. Better engagement, better outcomes. And aren’t we all seeking good health outcomes?
When the COVID-19 crisis emerged and began to evolve societal priorities, our clinical community of practice became even more critical. We have been able to tap into the holistic power of our clinical community to continue to help drive new care models and prepare us for a world in which virtual care and virtual care management offer a safety buffer for both our customers and our staff. Additionally, as the majority of Humana’s staff – including clinicians – were forced to work from their homes, having a robust clinical community allowed our clinicians to continue to stay connected and support each other as peers.
As COVID-19 evolves, we will continue to use our community of practice to refine our processes and continue to prioritize listening to our clinicians and involving them in the decision-making process.
HOW A THRIVING COMMUNITY OF PRACTICE WORKS
Many of the key strategies we use in developing Humana’s clinical community are likely applicable to broader organizations as well:
- Strengthen care managers’ ability to grow and impact care through mentoring and leadership development opportunities
- Develop a clinically led advisory board with executive sponsorship
- Solicit clinical subject matter expertise and input in new care models, development, and research opportunities
- Build a communication plan that highlights the clinical value to the community of practice and the broader organization
- Introduce multiple listening channels and establish an ongoing feedback loop
- Define continuous measurement goals, evaluate, and respond to community needs and impact
BELONGING AT WORK
From onboarding to ongoing well-being, recognition, growth, and development support, we intentionally focus on ensuring our case managers feel they belong at our company. One of the ways we’ve been able to focus on belonging with our newly hired case managers is through our Nightingale Outreach Program. Through this program, we are engaging and supporting newly hired case managers by pairing them up with an experienced, engaged Nightingale clinician to increase awareness of all opportunities, tools, and resources we have available within our clinical community. It is important for us to ensure that our clinicians feel a strong sense of belonging and part of a broader clinical community at Humana, even if they are working from home in a virtual setting.
Development initiatives. These are initiatives designed to grow our care managers’ skills and broaden their perspectives. This might mean supporting those seeking advanced degrees and specialty certifications, growing leadership skills, and business acumen, or simply enabling them to take part in continuous learning opportunities.
Our Nurse Career Rotation program, for example, offers nurses the opportunity to step outside their comfort zone and learn about the entire company, with deep dives into enterprise-wide objectives, the latest technology, or immersion into metrics the company uses to drive decision-making.
The goal is to embed clinicians in other lines of business so they get the big picture of how we operate. The benefits go in two directions: a clinician who understands the business and a company whose strategic business decisions are informed by the hands-on insights of the clinician.
Initiatives aimed at our clinicians’ well-being. The work of a clinician is already stressful. Add the uncertainty of the coronavirus pandemic, along with recent economic turmoil and racial strife, and stress is the new normal in 2020. To counter these stressors, it is more important than ever to bolster our clinicians’ whole health and invest in their well-being. We are continuously looking at opportunities to test new ways of supporting well-being, such as the most recent sit-to-stand desk pilot for work-at-home nurses who spend a lot of time at their desks. We also offer support that focuses on work-life balance topics such as physical fitness, healthy eating habits, financial security, and the flexibility to deal with childcare and school at home.
Employees who feel their day-to-day work complements their passions, strengths, and expertise are less stressed and significantly more resilient. We have seen from our annual associate survey that our investment in such initiatives has not only contributed to an increased sense of belonging, but also lower their perceived stress levels, decreased turnover risk, and produced higher engagement. We are continuing to work intentionally to implement initiatives to assist with coping skills, such as providing additional paid time off for associates whose lives have been upended by the pandemic.
Initiatives to honor and recognize our clinicians. People tend to be happier and more engaged in their work if they believe their efforts are appreciated and recognized in a meaningful way. 3 It is so vital to be intentional about celebrating your employees’ successes with internal recognition opportunities such as peer-to-peer and company honors and awards. Let your employees tell their success stories to their colleagues, or even to outside audiences. Establish an awards program in which particularly significant achievements are rewarded both internally and outside of the company.
Intentional and continuous communication. Institute processes that ensure regular dialogue between care managers and management, and among each other as peers. Such touchpoints might include town halls, podcasts, storytelling, peer-to-peer forums, intranet conversations, and focus groups. Our nearly 40-member Nursing Advisory Council and Social Services Advisory Council includes nurses, nurse practitioners, social workers, telephonic care managers, and many other disciplines whose input is factored into our decision-making processes.
Your organization will have their way of doing things, of course; there is no single path to success. As long as the people closest to the action, the care managers, have a strong voice in determining its future, I have confidence you will get there.
, RN, CCM, is vice president, chief nursing officer, Humana. In her role as chief nursing officer, Kathy oversees Humana’s strategy of improving the experience of Humana’s community of nearly ten thousand nurses, care managers, and social workers, and promoting a culture that engages, values, and inspires clinical professionals while impacting health outcomes. Focus areas include clinical quality and innovation, clinician growth and development, and clinician engagement and recognition. She also leads initiatives to support the health and well-being of Humana’s clinical communities leveraging partnerships across the Humana enterprise as well as external partnerships such as the ANA Healthy Nurse Healthy Nation initiative and the IHI Joy in Work Collaborative.
Kathy is a registered nurse, licensed in New York, New Jersey, Florida, and Connecticut. She is a board-certified case manager and a member of Sigma Theta Tau, Chi Phi Chapter. Kathy is a member of the board of directors for SeniorBridge, as well as serving on the board of trustees for the American Nurses Foundation. She is a current member of The American Nurses Association, The Case Management Society of America, The American Organization of Nurse Leaders, and The American Association of Managed Care Nurses.
