In This Issue

Renee Mattaliano takes the reader on a team-oriented tour that demonstrates the best care and early successful outcomes for ill/injured employees. She walks with the reader along the path where case managers and disability managers work hand in hand to accomplish the successful return to work. She has developed and now shares with the reader her "Tips for Cooperative Working Relationships."

Kimberly A. Ferris reviews first the three major contacts on a workers' compensation file: injured worker, provider, and employer as the means to obtain quality care with timely and cost-effective outcomes. She reminds us of the importance of the claims adjuster's role for a successful outcome.

She outlines the need to provide updates to the adjuster of any medical and return-to-work changes on the file. She outlines the need to educate the adjuster regarding any concerns, inconsistencies of the injured worker, and red flags. Each of the contacts is ongoing throughout the life of the file, which will bring quality medical management and cost-containment on any given file.

Jacqueline Perkins and Vineta Mitchell bring to us a strong image of the role that field case managers (FCMs) play in healthcare. They take their image to another level by saying FCMs have a unique position that affects continued quality improvement and can prevent many of the repeat hospitalizations that result from uncoordinated and fragmented case management. Provision of the FCM services in today's healthcare environment is an innovative approach to bridging the gap in that healthcare needs of the individual improve outcomes and reduce recidivism. This position is the means to stop the revolving door leading to repeat hospitalization and missed opportunities for quality improvement in the management of chronic illness. This is FCM's impact to reduce healthcare cost.

John Lowe asks the reader the following question: "Physical rehabilitation of injured workers: At what point should it start?" Once he has our attention, he sets the stage for his discussion. Physical rehabilitation is often a primary component in the return-to-work process; however, there is no generally accepted consensus regarding when an appropriate referral for physical or occupational therapy is appropriate. Lowe provides us six situations in which early referral for rehabilitation should be considered. Discussion closes by pointing out that the physical rehabilitation must be relative to the work demands of the injured worker. Then set treatment goals that are specific to the return-to-work process. The physical rehabilitation must be designed to successfully enhance the injured worker's return to work.

Frances Snowden, BS, RN, CRRN, CCM, Contributing Editor