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.

Patient-centered care is a simple, evidence-based way to improve care transitions and patient outcomes. Hospital case managers can benefit from learning more shared decision-making tactics.

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.

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.