Choose your new case managers carefully

Make sure they fit in your department

If you hire the wrong person for a case management job, you’re at a disadvantage from the start, says Beverly Cunningham, RN, MS, vice president of resource management at Medical City Dallas Hospital. “You can teach case management, but you can’t teach the personal characteristics it takes to be a good case manager,” she adds.

Good case managers need to be flexible and not afraid to have uncomfortable but crucial conversations with patients, family members, and sometimes other providers. They need critical thinking skills and the ability to be creative and think outside the box, adds Peggy Rossi, BSN, MPA, CCM, a retired hospital case management director who now is a consultant for the Center for Case Management.

She advises case management directors to take their time during the hiring process. Don’t look to fill the position. Look to fill the position with the right person, she says.

Look at the personality of case management candidates to see if they fit into the culture of your hospital. Assess their knowledge of the case management process. Recognize that it might be difficult to find someone with the knowledge and skills you need, and that’s where the orientation process comes in, Cunningham says.

“Case management directors may not necessarily want to hire an experienced case manager who can hit the ground running. That ground might not be the ground they want them to be standing on,” adds Catherine M. Mullahy, RN, BSN, CCRN, CCM, president and founder of Mullahy and Associates, a Huntington, NY, case management consulting firm. Sometimes case managers from another organization find it hard to adjust to how their new department operates or bring in bad habits from the other organization. “It may be better to take someone who is not experienced in case management and teach them what they need to know to work in your department,” she says.

Make your staff part of the interview process and solicit their feedback. At Medical City Dallas Hospital, case management candidates meet with a team of four case managers, four social workers, or both case managers and social workers, depending on where the person will be assigned. “We want to make sure that the new hire will fit into the team. The staff often asks a question I wouldn’t think of asking. I value their input, but the director makes the final decision,” Cunningham says.

Floor nurses can become effective case managers but only if they understand the job description and realize that case management is not a hands-on job, Rossi says. Sometimes floor nurses may think they want to be case managers but they don’t know what case managers really do and are easily disenchanted with the job, Mullahy says.“The role of a case manager is very different from the role of a floor nurse and requires different skills,” she adds. Make sure the case management candidates know what the job entails. Consider allowing nurses who want to be case managers to follow along with someone for a day or longer and find out what goes on in a case manager’s day, Mullahy says.

Case management directors need to assess case management candidates to make sure they will be good case managers. “Someone may be a great emergency department nurse but isn’t comfortable reaching out to families or working with organizations outside the hospital,” Mullahy says.

Match the candidate’s clinical knowledge to the area to which the new case manager will be assigned, Cunningham suggests. “Case management today is very specialized and requires specialized knowledge. It would not be a good idea to put someone in the ICU who has never worked in the ICU,” she says.

The best case managers are those for whom the position is more than just a job, Mullahy says. “You can give case managers computers and software that will help them do their job, but nothing can replace intellectual curiosity and a caring heart,” she says.