Throughout my career as a nurse, a certified case manager (CCM), and an academic, I have witnessed how the human aspect of caring and the science of evidence-based practice (EBP) are two halves of a complementary whole. Separately, each is powerful; together, they are even more impactful in the pursuit of health care goals. Professional case management uniquely demonstrates the importance of this combination through human interactions of care provision and delivery, coupled with a scientific approach that employs EBP.
The human side is defined by advocacy-the primary role of case managers, especially those who are board-certified. As advocates, case managers assess the needs of individuals, devise a care plan in support of each person's goals and objectives, and coordinate care accordingly. Advocacy is key to achieving three specific outcomes, as stated by the Case Management Body of Knowledge (CMBOK, 2012-2022). The first is fostering autonomy and independence for the client receiving case management services, who is known in some care settings as a patient. The second is educating clients about their rights and the services, resources, and benefits available to them. Third, advocacy facilitates informed decision making that is aligned with each client's beliefs, values, and interests (CMBOK, 2012-2022).
The scientific component is embodied by EBP, composed of research, data, and an evolving body of knowledge. Evidence-based practice is a valuable resource for case managers as they engage in their roles and responsibilities in care settings across health and human services (Treiger & Kurland, 2021). Evidence-based practice initiatives need leaders and contributors from diverse interdisciplinary teams to be successful (McNett et al., 2021). Evidence-based practice encompasses high-quality evidence, clinical expertise, and patients' preferences and values (Melnyk & Raderstorf, 2021). Evidence-based practice not only improves patient outcomes, safety, and health care quality but also fosters clinicians' engagement in their practice (Melnyk et al., 2017). Case managers are in a unique position to foster EBP by advocating for patient preferences every day.
By bringing together the human and the scientific, professional case managers also demonstrate leadership as they make a measurable, positive impact. Case managers are integral to evidence-based leadership, which is a problem-solving approach to influence and lead organizations or groups in EBP efforts (Melnyk & Raderstorf, 2021). We have seen this throughout the COVID-19 pandemic in particular, as case managers have served the specific needs of individuals, while continuously educating and informing themselves about evolving care and treatment protocols (Baker et al., 2021). As we look ahead, with increased complexity in health care, professional case managers must deliver the human side of care, while relying increasingly on science and EBP. To me, this duality embraces the heart of case management.
Passion for Research and Science
As a new nurse at an academic health center, drawing on the scientific knowledge I had gained from nursing school combined with insights and guidance of more experienced colleagues allowed me to grow. Experiencing complex challenging situations deepened my appreciation for just how much we rely on critical thinking skills to solve problems.
My career evolved into the next phase when I became a nurse educator at a university. Having always appreciated what my education did for me, I viewed academics as a tangible way to give back through my love of teaching and preparing others with the knowledge, skills, and experiences they need to practice competently. Moreover, I did not view teaching as a departure from clinical practice but rather as another area of practice.
As a nurse educator, I have been interested in identifying essential professional behaviors that new nurses should possess at this time of greater complexity and tremendous change in health care. To answer this question, a survey of nurse leaders was conducted to identify which behaviors and traits nursing students needed to learn and develop in the classroom (Sortedahl et al., 2020). Nurse leaders ranked communication as the most important category of all, which included communication with patients, families, health care professionals who write orders, and nurse colleagues. Within this category, nurse leaders rated communication with patients as the highest item of all. The importance of communication to nurse leaders is notable. As case managers, communication is key to our practice. Professional case managers are known for their communication skills as they assess clients, determine care plans, and support informed decision making. But there are other aspects to our communication, such as supporting colleagues and ensuring that they have the latest information they need, especially as it relates to EBP.
We've seen how case managers have responded to the challenges of the COVID-19 pandemic (Baker et al., 2021). Now, moving forward, case managers' advanced communication skills with patients and stakeholders across the health care continuum will continue to be vital to navigate current and future changes. Importantly, communication needs to be grounded in EBP as new information and research emerges in areas such as vaccination, communicable disease control, and health care delivery.
Nurse leaders ranked self-awareness as the second most important category for new nurses (Sortedahl et al., 2020). The ability to accept constructive criticism and learn from failure, as well as identifying one's own limitations and strengths, was considered essential. We learn together how to tackle challenges in health care, but we also have opportunities as individuals to reflect and grow.
Looking ahead, as we consider professional succession across health and human services, those of us who are experienced have an obligation to help develop, mentor, and support the next generation, whether formally through teaching or informally through peer-to-peer mentoring. Case managers have tremendous opportunities interacting with students or new professionals across the continuum of care. From sharing our experiences anecdotally to encouraging an evidence-based approach, we can help these new colleagues see what we have embraced throughout our careers: The human touch of caring for others as individuals has never been more important-and the best way to do that is in combination with research and science, through EBP.
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