Michelle Baker, BS, RN, CRRN, CCM, is the 2020-2021 chair of the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that certifies case managers. She is also Associate Director, Network Services, for Paradigm Catastrophic Care Management. Her primary areas of focus include administrative management of workers' compensation catastrophic nurse case managers and program development/implementation and training of the clinical network.
Sheila Nelson, MSN, RN, CCM, is a CCMC Commissioner and Secretary of its Executive Committee. She is a clinical practice specialist for Kaiser Permanente Washington and a member of its Care Management Programs and Strategies Team to direct and facilitate clinical practice innovation and best practices to achieve cost, quality, safety, and service outcomes through the development and delivery of clinical education.
Prof Case Manag. 2021;26(2):62-69. doi: 10.1097/NCM.0000000000000484.
Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease known as COVID-19, case management has emerged as a critical intervention in the treatment of cases, particularly for patients with severe symptoms and medical complications. In addition, case managers have been on the front lines of the response across the health care spectrum to reduce risks of contagion, including among health care workers. The purpose of this article is to discuss the case management response, highlighting the importance of individual care plans to provide access to the right care and treatment at the right time to address both the consequences of the disease and patient comorbidities.
The COVID-19 response spans the full continuum of health and human services, including acute care, subacute care, workers' compensation (especially catastrophic case management), home health, primary care, and community-based care.
From the earliest days of the pandemic, case managers have assumed an important role on the front lines of the medical response to COVID-19, ensuring that procedures are in place for managing a range of patients: those who were symptomatic but able to self-isolate and care for themselves at home; those who had serious symptoms and needed to be hospitalized; and those who were asymptomatic and needed to be educated about the importance of self-isolating. Across the care spectrum, individualized responses to the clinical and psychosocial needs of patients with COVID-19 in acute care, subacute care, home health, and other outpatient settings have been guided by the well-established case management process of screening, assessing, planning, implementing, following up, transitioning, and evaluating. In addition, professional case managers are guided by values such as advocacy, ensuring access to the right care and treatment at the right time; autonomy, respecting the right to self-determination; and justice, promoting fairness and equity in access to resources and treatment. The value of justice also addresses the sobering reality that people from racial and ethnic minority groups are at an increased risk of getting sick and dying from COVID-19. Going forward, case management will continue to play a major role in supporting patients with COVID-19, in both inpatient and outpatient settings, with telephonic follow-up and greater use of telehealth.
自严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)爆发,以及被称为 COVID-19 的疾病以来,病例管理已成为治疗病例的关键干预措施,特别是对于有严重症状和医疗并发症的患者。此外,病例管理者一直在医疗保健领域的第一线应对,以降低传染风险,包括医疗保健工作者。本文旨在讨论病例管理应对措施,强调个人护理计划的重要性,以便在适当的时间获得适当的护理和治疗,以解决疾病和患者合并症的后果。
COVID-19 应对措施涵盖了整个卫生和人类服务的连续体,包括急性护理、亚急性护理、工人赔偿(特别是灾难性病例管理)、家庭健康、初级保健和基于社区的护理。
从大流行的早期开始,病例管理者就在 COVID-19 医疗应对的前线发挥了重要作用,确保管理一系列患者的程序到位:那些有症状但能够自我隔离并在家中照顾自己的患者;那些有严重症状需要住院的患者;以及那些无症状但需要接受自我隔离重要性教育的患者。在整个护理范围内,对急性护理、亚急性护理、家庭健康和其他门诊环境中 COVID-19 患者的临床和社会心理需求的个性化应对,都以病例管理的既定程序为指导,即筛选、评估、规划、实施、跟进、过渡和评估。此外,专业病例管理者受到倡导等价值观的指导,确保在适当的时间获得适当的护理和治疗;自主权,尊重自决权;正义,促进资源和治疗机会的公平和平等。正义的价值也解决了一个严峻的现实,即来自种族和族裔少数群体的人感染 COVID-19 并因此患病和死亡的风险增加。未来,病例管理将继续在支持 COVID-19 患者方面发挥主要作用,无论是在住院还是门诊环境中,都将进行电话随访,并更多地使用远程医疗。