Patient involvement in CM may require permission
Question: What types of case management models, if any, require documentation of a patient's consent to participate in the case management process?
Answer: Most case managers who spoke to Hospital Case Management say there's no need to worry with the added burden of obtaining patient consents for standard inpatient case management.
"In most instances, when the patient signs the consent to enter the hospital, the hospital case management role is within the context of the delivery of services," says Helen Thompson, a case management consultant with HMT Inc., in Briarcliff, NY. Therefore, "the normal consent obtained on admission to a hospital would cover anything the case manager does because within the hospital setting, most case management roles are activities that are performed in the hospital anyway," adds Thompson.
Consent issues hinge upon position's scope
Case managers who are working across multiple systems, however, have more consent concerns, she adds. Catherine Mullahy, RN, BS, CRRN, CCM, founder and president of Huntington, NY-based Options Unlimited, a case management and disability management consulting firm, agrees with Thompson. Obtaining patient consent "depends greatly on how the case manager position is structured by the hospital or the case management department," she says.
"Consent forms need to cover the scope of practice for the practitioner. If you need the patient to cooperate and understand that yes you are going to be arranging services on [his or her] behalf, and you may be referring them to a community resource agency, a consent form is a good idea," explains Mullahy.
A diabetes patient who is referred to an outpatient case management program involving phone calls, clinic visits, and blood glucose monitoring, for example, should sign a patient consent or agreement form.
If you're still in doubt, Mullahy recommends working closely with hospital counsel and, depending upon how the job description of the case manager is detailed, also working with the risk management department. Case management roles that are being defined or redefined, should always mesh with risk management and malpractice policies, she continues.
"As more [case managers] extend outside the hospital to challenge or review treatment options, and as patients become more involved in their own decision making, perhaps consent will become more important for case managers," says Thompson.
[Editor's note: In this issue, Hospital Case Management begins a new feature to answer your questions. Questions will be answered from HCM editorial board members, experts in the field, or peers in similar settings. If you have a question you would like answered, simply write a brief note or call the HCM editor. Write: HCM Reader Question, P.O. Box 740056, Atlanta, GA 30374. Telephone: (404) 262-5467. Fax: (404) 261-3964.] *
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content