Dana Deravin Carr

Purpose/Objectives With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. Primary Practice Settings All settings, particularly acute care hospitals and integrated delivery systems. Implications for Case Management Practice The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty. Case managers use their leadership ability to advance and support patient-centered care delivery by promoting continuity of care, enhancing communication, and integrating the goals of patient care. The utilization of formal and informal leadership strategies provides opportunities for case managers to positively impact the vision and values of the organizations they serve. Professional nursing partnerships provide opportunities to actively support, develop, coach, and mentor the larger nursing community.

More than 5 million patients are admitted annually to intensive care units (ICUs) in the United States. As the life expectancy of the population continues to lengthen, we should expect to see a proportionate increase in the burden of acute and chronic illness as well as a rise in the demand for critical care services. The case management dyad team of nurse case manager and social worker enhances and supports the critical care team through the implementation of collaborative interventions that focus upon the (1) minimization of inpatient transitions, (2) reduction of cost by decreasing the length of stay, (3) promotion of patient and family satisfaction through efforts of advocacy, and (4) enhanced discharge planning. Hospital ICUs. In the critical care setting the professional partnership of the RN case manager/masters in social worker (RN/MSW) dyad is a core component in the linkage of the ICU support system and it enhances the functioning of the ICU multidisciplinary team. The efforts of the dyad team are congruent with the goals of patient care, with the desires of the family, and with the mission of the organization. Shared goals and a shared commitment to professional practice provide the essential building blocks of the dyad relationship. The dyad structure presents an opportunity for RN case managers and social workers to integrate their strengths and skills in a collaborative patient-centered effort. The RN/MSW dyad structure as a model for case management practice promotes continuity of care and strengthens professional relationships. The case manager and the social worker have many shared responsibilities; therefore, a partnership that promotes continuous collaboration and communication is essential to the achievement of successful patient care outcomes. The professional partnership that evolves, as depicted by the RN/MSW dyad structure, enhances the organizations' mission to deliver quality patient-centered care.

In this new era of patient safety, the case manager, as an advocate and facilitator of care, has a pivotal role on the front line of healthcare delivery. Effective communication and collaboration between disciplines is key to the promotion of patient safety, and ultimately the avoidance of life-threatening medical errors. Across the healthcare continuum and within hospitals in particular, patients are routinely transferred from one service to another, from one level of care to another, or from one provider to another. As patients are stabilized and transitioned through the hospital system, there are multiple hand-offs of care or care transitions that can often expose the patient to fragmented service and increase the risk of communication breakdown. Ineffective hand-offs can result in a disruption of continuity between one level of care and the next. In a culture that places a strong emphasis on patient safety, case managers can facilitate opportunities that ease care transitions whereby a change in venue is no longer perceived as a disruption in the flow of care but rather is viewed as a coordinated changeover where cautious and comprehensive communication sets the tone for the continued delivery of safe and effective healthcare.