A multidisciplinary group at Zuckerberg San Francisco General Hospital has created an ED Social Medicine (EDSM) team to deliver better outcomes for patients who present to the ED and to lift some burden off the shoulders of providers. In operation since 2017, investigators are finding the EDSM team approach is delivering dividends on multiple fronts. They also believe they have created a roadmap to follow for other facilities struggling with similar concerns.
Case managers make a difference in the lives of their patients, even when patients are only in the hospital briefly. This is especially true when a patient is undergoing a life-changing or traumatic event, like limb amputation. Case managers can help guide the patient on what to expect during recovery and after. In some cases, they might be the only person who can help a vulnerable patient find help for a successful and less traumatic experience.
As of 2020, more than half a million people were homeless in the United States. When a case manager cares for a patient who has no home or permanent place of residence, the plan can change quickly. While the general outline of the case management process might stay the same when serving a homeless individual, there are additional items to consider.
Every day, hospital case managers must make decisions — large and small — that affect the lives of their patients. Some of these are ethical decisions — what the case manager “ought” to do in a given situation. Since many decisions must be made quickly, hospital case managers should consider their ethics and plan ahead rather than reacting solely in the moment.
The keys to preventing and overturning payer denials are to collect data to identify problem areas and to train staff in best practices. The case management team should understand the information each payer wants and how best to share those data.
The Centers for Disease Control and Prevention reported that nearly 20% of U.S. adults were living with a mental illness in 2019 — and that percentage shockingly doubled to 40% in 2020. For young adults in particular, the rate of suicidal thoughts rose to an alarming 25%.Since hospital case managers typically have a front-row view of what is happening in the healthcare world, they no doubt have seen these statistics firsthand.
In some ways, it seems that it is nearly impossible to please both the hospital administration and the patients and their families, especially in times of crisis. However, the case manager is in a unique position to bring both along — assuming they have the right tools to do so. Without the help of a wise and invested hospital case manager, the chances of a positive experience for the patient are lower, and hospital spending is more likely to be higher.
Almost two-thirds of healthcare workers in thousands of skilled nursing facilities have turned down the COVID-19 vaccine, even though the mortality rates of long-term care residents are among the highest of any population. Historically, long-term care workers have shunned influenza vaccinations, citing skepticism about the vaccine’s efficacy or that they do not get the flu. The COVID-19 vaccine raises its own set of suspicions.
Patients often present to the ED with behavioral health concerns, but psychiatric experts recognize the environment is hardly optimal for easing anxiety or calming a troubled mind. Further, patients with psychiatric concerns often wait in the ED for extended periods before they are connected with appropriate care, a time that can be fraught with danger for individuals at risk for self-harm. Recognizing the safety challenges at issue, a multidisciplinary team at Massachusetts General Hospital developed and implemented a protocol aimed at protecting such patients.