BY, RN-BC, CCM
Each month, we will look at a case management leader recommended by one of the past presidents of CMSA. The criteria for a nomination is that the professional has contributed to the practice of case management and has inspired others to step up to become leaders in their area of case management.
In this issue, Past President of the Case Management Society of America Sandra Lowery, RN-BC, CCM, founder of CCMI Associates, recommends Suzanne K. Powell, RN, BSN, MBA, CCM, CPHQ, editor-in-chief of Lippincott’s Professional Case Management Journal.
Here are a few questions that will give you insights into this dynamic leader.
Q. WHAT IS YOUR CURRENT ROLE?
A. I have two current case management roles: One is the editor-in-chief of Lippincott’s Professional Case Management Journal (PCM Journal) for the past 20 years. Second, I am a case manager at Mayo Clinic Hospital in Phoenix, Arizona. In both, I am grateful for the case management journey that has led me to “today.”
Some history: In the 1980s, I was a case manager for the largest Medicaid Managed Care plan in Arizona. Not having any role models, I fought for the patients every way I could. Since I did not know better nor knew any boundaries, when Chuck (an 18-year-old with leukemia) needed an autologous bone marrow transplant to save his life – which was not a covered service for Arizona Medicaid at the time – I went to the top of the Arizona Medicaid leaders and respectfully became a “persistent” case manager to advocate for my patient. The good news was that these transplants became covered; the bad news is that Chuck was too ill to receive help from it once it was covered.
Next, I became the second case manager at a large teaching hospital in Phoenix. After learning case management by the seat of my pants and realizing that there was little training material for case managers, I wrote my first case management book. Today, I have authored several to assist case managers in their practice. Here are a few that readers can check out: Powell, S.K. (Ed.) Case Management Society of America’s Core Curriculum for Case Management, 3rd edition, Philadelphia: Lippincott, Williams, & Wilkins. and Powell, S.K., & Tahan, M.H., Case Management: A Practical Guide for Education and Practice, 4th Edition (2019). Philadelphia: Lippincott, Williams, & Wilkins.
My next type of case management was at the QIO (quality improvement organization) for Arizona, where I was the director of case management for self-funded plans and managed healthcare projects that spanned all acute care hospitals in Arizona. In this role I learned A LOT about Medicare regulations that affect the work that case managers are still responsible for today.
Lastly, I became the manager of the nurse case managers at Mayo Clinic Hospital in Phoenix, Arizona. After five years of joys and trials, a remote position became available, just as my life needed something less stressful.
Q. WHAT MODEL OF CASE MANAGEMENT DO YOU SEE AS BEING MOST EFFECTIVE IN TODAY’S CURRENT HEALTH CARE ENVIRONMENT?
A. As you can see from the previous question, there are many types of case management. So, the short answer is: whatever works for your patients in order to give them the best chance at a healthier life. Since I have been in acute case management for most of my years, I believe the triad model works well for today’s acute environment. Here we have nurse case managers and social workers teaming with the utilization management RNs. Daily rounds on all floors bring these three groups together, along with the physicians (including physician advisors), nutritionists, bedside nursing and therapies.
The triad is not new or innovative, as it revisits many of the tenets I saw in the 1980s. However, healthcare is very different now, with tougher criteria, more denials of care and a greater specificity of patients’ issues. To meet the healthcare needs of the patients, the organizations, fellow healthcare workers and everyone’s fiscal health, this model allows everyone to focus on quality care and efficient throughput. When we used to “do it all,” there was a tipping point where many things fell through the cracks, and burnout ensued.
Q. HOW HAVE YOU MENTORED CASE MANAGERS TO BE LEADERS?
A. I encourage case managers to write manuscripts on innovative models they are working on and speak at national conventions, often about their writings. This not only spreads good ideas that other case management models can build on but moves professionals out of their comfort zone – necessary for growth. Some of these professionals have gone on to write case management books and teach at universities.
As editor-in-chief of PCM Journal, thoughtful choices of manuscripts and even requesting someone to co-write an editorial with me on topics that are timely and important are designed to bring out the best of leadership.
Q. NAME ONE OR TWO OF THE CHALLENGES YOU SEE FACING CASE MANAGERS.
A. First, the aging of the case management workforce is a concern. Many of the “pioneers” are gone or retiring. Still, with all our foibles and lofty goals as we learned the practice of case management with few role models, I am encouraged to see younger colleagues with limitless energy to work for today’s population (including the aging case managers).
Second, we don’t know what we don’t know. We had no inkling of COVID in 2019, and we will have new challenges in the coming decades. As a bedside RN in the 1980s, I never could have foreseen craniotomies discharged the next day, or even knees and hips! We must be brave, flexible and do our best to stay ahead of the curve.
Q. WHERE DO YOU SEE THE PRACTICE OF CASE MANAGEMENT GOING IN THE NEXT FIVE YEARS?
A. Some things will always remain a basic tenet of case management, such as being a patient advocate, treating everyone with respect, or going the extra mile. Over the decades, case managers have become a critical part of healthcare; where once I was looked upon as a spy (FBI?), now we are looked to as the people who solve some of the most important problems. However, that comes with a price, and the cost is often stress. As leaders it will always be important to watch your staff closely, listen to them carefully, teach them techniques that increase resilience, and give grace whenever you can.
Q. ANY CLOSING THOUGHTS?
A. 2020 has been a year like no other – and hopefully in our lifetime, we will not have to repeat something like this. What I saw in 2020 was a country of dedicated case managers who were willing to “do whatever it takes” to get us through the pandemic. I am humbled and proud to be a part of this healthcare family.