Dorothy Zydowicz and Lewis Vierling enlighten us on how to gain exceptional results. First, we have to consider that teamwork provides a complete approach to patient-centered care. This concept is underwritten by the statement that the patient is to receive the best care possible and a well-directed multidisciplinary approach is essential. Next, Zydowicz and Vierling discuss methods to provide this team model. The center of this dynamic team model is the telephonic case manager, providing coordination of care to ensure continuity for the patient. This model demands that the case manager measure outcomes-including clinical, financial, and interpersonal-the satisfaction of the individual family or payor. The authors conclude by setting out this guideline: outcomes guide our practice as stewards of healthcare resources.

Lori Rice and Michael Garrett outline strategies to improve quality of care while managing cost. First, they define the workers' compensation concept. It is a social insurance concept developed to provide no-fault coverage in the form of defined benefits, available to employees who have become injured on the job.

Coverage for workers' compensation is available through several options provided by the funding party. Web site references provide you the ability to interpret the proper benefits to each of your patients. Next, they point out that workers' compensation payors are concerned about controlling their exposure to large monetary settlements. Because multiple jurisdictions and all the involved parties have a vested interest, the case manager early on must establish a position of patient advocacy. This will ensure that mutually agreed-upon goals can be established. The emphasis at this point is that transitional work plans be developed to provide a successful return-to-work solution. A table is provided to give more depth to discussion concerning Utilization Management and Independent Medical Examinations. Their vision for the case manager is to truly focus on controlling costs, improving quality, advocating for injured workers establishing a solid relationship with the healthcare providers, increasing knowledge and skills, and adhering to professional practice standards. These high standards that are being met routinely in the workers' compensation arena prove that case managers are meeting the challenges of excellence.

Frances Snowden, BS, RN, CRRN, CCM

Contributing Editor