With payers’ increasing emphasis on costs over the entire episode of care, case managers need to expand their address books to add resources throughout the community, says Cheri Bankston, RN, MSN, director of clinical advisory services for Curaspan.

“Hospitals have to be proactive and prepare for the future, so when patients are being discharged the staff will have resources at their fingertips,” she says.

Bankston advises case management directors to collaborate with staff and share known resources, and continually update the list of agencies and services.

To begin, case managers should contact each agency and find out what services they provide, any limitations, the criteria to receive the services, and any information they need to provide services for your patients, she says.

Consider inviting representatives of the organizations to your hospital to inform the case management staff about the services they provide and how case managers can help their patients to access the services. “Most agencies are more than happy to send someone in to speak to the staff about the type of services they offer,” she says.

Once you have all the information, utilize tools to easily identify community organizations that can help with their patients’ individual needs, Bankston says.

If at all possible, create or utilize an electronic platform so staff can quickly match community resources with patient needs. “Many software companies offer a way to automate this kind of information,” she says.

“Whether it’s a hard copy or a computerized version of the list, there has to be an easy way for the staff to search the list to find and match patients with appropriate resources,” she says.