To all of our case management colleagues we would like to say.... Job well done! Take a little time to reflect on the role you play in the complex world of health care and how important your skills, expertise, and compassion are, as you connect with patients, families, and colleagues to remove barriers, overcome challenges, and reduce fears and stress... as best you can.
Looking back to the first days of defining case management, several of us remember, or have heard about a phone call asking if we could come to a meeting where individuals working in the field of case management were going to discuss the concept of a case management organization. It was an intriguing phone call as the person on the other end was tentative as to what the need or vision was or could be. ... but the initial thought was "leaders" who were working in the field should have a place to discuss the uniqueness of the role. Thirteen people came to Chicago, with no financial or company support, several were called, including the late Mary Ann Gambosh and asked their opinions... and the discussion began.
We were geographically diverse, practicing in different community settings, academic medical centers as well as other hospital settings, payor organizations, and in the field of worker's compensation. We were nurses and social workers who were grateful that we took a "risk" and came to a meeting to explore this new role called "case management." We found our commonalities quickly as well as recognizing our differences and how they brought richness to our roles and our respective teams.
We started by asking questions:
Do we all define case management the same way?
Do we all play the same role as case managers?
Do we all practice in the same practice settings?
What do we do the same and what do we do different?
What is our value to the patients and families we serve, as well as our value to the health care team?
Simple questions? Hardly. At the time we did not realize that it would ignite years of debate that continues to the present day!
That meeting and the ones that followed were considered the "start-up" meetings for a professional organization. We debated what the name would be, eventually settling on The Case Management Society of America. We wanted a name that would acknowledge our diversity and embrace ALL that practice in the role of a case manager.
We debated the role that case managers played in the "new" managed care arena, and realized that the role would evolve over time as managed care and health care in general would evolve in ways we could not even foresee. But we continued to focus on the fact that we all had skills to share, knowledge to impart, and a role to play that is vital to the practice.
And the one thing we did not debate was that we were strongest when we acknowledged and respected the premise that case management is a practice that is built on skills, and knowledge that comes from various health care practitioners. Professional Social Workers and Professional Registered Nurses working together is the cornerstone and will always be the "heartbeat" of the practice. One profession is not above, one is not below, and working together exemplifies the value and expertise necessary to work through the complexities of case management and health care today. We sit at a round table, equally positioned to collaborate rather than any one being at the head of the table dictating the direction of professional practice.
The simple premise of launching The Case Management Society of America was to engage case managers as a group of professionals who could speak to health care through a collaborative model and reduce the fragmentation, inconsistency, and duplication of interventions within the health care arena. We believed that by working together and leading the transition of care initiatives, we would improve the health care landscape for all involved. It would be reflected in the question: "Is this care you would want for yourself... or your loved one?
Yet today, when we travel across the country, we observe increased fragmentation, less personal, face-to-face communication, and more reliance on communication tools... and unfortunately a lack of respect, and at times trust, for colleagues that are part of the care management process. There are emerging care coordination models defined by evidence-based initiatives; each promotes interprofessional practice as a means to achieve quality patient-centered care. This focus on interprofessional teamwork is now fused into higher education as the means to provide education at the gateway of workplace entry. In this way, health care practitioners learn how to intentionally work together in a manner that denotes mutual respect and valuing of expertise across all care team stakeholders. These models are another opportunity for case managers to engage in practice that speaks directly to the professional standards to which we hold ourselves accountable.
While we all want the best working environment for ourselves, the best transition of care process for those we serve, and the most trusting relationships with those on our teams, we strongly suggest looking in the mirror. We should not be cloistering ourselves as social work case managers and nurse case managers. We are, simply put, Professional Case Managers. In this era of cross-continuum care management, those following a path of segregating case management into separate camps based, not only on educational background but also on practice setting, level of experience, or any other artificial divider are misguided at best.
It is up to all of us to value our colleagues, respect the skills and knowledge that everyone brings to the process ... and Celebrate together.... We Social Workers and Registered Nurses are Case Management ... and we are at our very best when we work TOGETHER!