EXECUTIVE SUMMARY
Case managers can add to their skill set of communication and care coordination by focusing on relationship-building.
- First step is to care for oneself by walking regularly or standing to avoid the stress of long hours of sitting at a desk.
- The second step is to improve the relationship with other healthcare providers through meeting people face to face, complimenting people when they’ve provided help or information, and attending meetings.
- When steps one and two are taken care of, case managers’ relationships with patients also will improve.
Case managers (CMs) are experts at communication and care coordination. Their organizational skills might be off the charts. But even with all of these assets, they could be performing below their potential if they are not improving one skill area: relationship-building.
“Relationship-based care is a model for transforming practice,” says Donna Wright, BSN, MS, RN, consultant with Creative Health Care Management in Minneapolis.
Relationships include the ones case managers have with themselves, with their colleagues, and with their patients, Wright says.
“You need all three relationships,” she says. “We’ve seen organizations that only are there for patient-centered care, but healthcare professionals cannot be terrible to each other and then still care for the patient; it doesn’t work.”
Likewise, case managers need to care for themselves in order to realize their full capacity on the job.
For example, case managers can become deskbound, which studies are beginning to show is poor for one’s health. Researchers have found that people have a decreased ability to concentrate if they are sitting or standing in one position for more than an hour, Wright says.
“Sitting as a case manager for hours at a time can cause you to be unhealthy, and you are less able to concentrate as the day goes on,” she says. “You need to get up and move around, and then your brain starts to function better.”
Wright has experienced the benefits of better self-care personally: “I’ve gotten into those traps of sitting and writing for six hours a day and getting tired and fatigued,” she explains. “Then I started walking 10 minutes twice daily and that changes things.”
Another step in improving relationships is to get to know your team, Wright suggests.
“You need to know the teams you’re working with,” she says. “So if you’re a cardiac case manager, then you better be hanging out with cardiac people.”
Trust begins to be built and productivity improves when people get to know their colleagues well, she adds.
Wright offers this anecdote as an example of the benefits of relationship building: “I remember going to a nursing home when I was the manager of patient care,” Wright says.
She called a nurse at the nursing home, and before she could relay her compliment, the nurse said, “What did I do wrong?”
Wright told her that nothing was wrong, but that her nursing note was perfect. “Your note saved me many hours of work,” she says.
The nurse had written in the note that the patient had a mental disability that wasn’t obvious. Since the person was coming in for a surgical procedure, the information about the patient’s mental status enabled Wright and the team to suggest changes to the surgical area to accommodate the patient’s limitations.
“Most people wouldn’t put it in the transfer note as beautifully as she did,” Wright says.
“The case manager has to be the center of everyone’s world and lift up the threads,” she notes. “When you have someone help you do that, you can get so much more efficient.”
Case managers can get bogged down in data: “We get tons of data, but we don’t always get the story, and the case manager has to get the story as fast as possible,” Wright says.
Another time, Wright walked down to the hospital’s lab and thanked the people working there for turning around a test within four hours of blood draw. The speedy work made it possible to identify the patient’s condition and get treatment started.
“After I thanked them, the lab would call me all the time to say, ‘Just wanted to make sure you got that lab report,’” she recalls.
Behind every instance when a case manager works with other healthcare professionals, there is a patient who needs everyone to collaborate as efficiently as possible, Wright says.
Sometimes it seems that the system has removed the “care” out of care managers, so it’s up to each case manager to put it back in, starting with caring for themselves, she adds.
“We’ve got to care not only for the patient, but for everyone who is taking care of them and helping as part of a team,” Wright says. “Then I feel good about being a care manager.”
Case managers can add to their skill set of communication and care coordination by focusing on relationship-building.
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