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New York City struggled, as did other hotspots. Patient care units sprung up in public spaces. Busloads of out-of-state nurses, medical residents, and retired doctors, nurses, and therapists pitched in. To expedite patient care, insurance companies waived copays and deductibles. Discharge planning regulations were relaxed. Paperwork took a back seat, as all efforts were directed toward patient care. All this was due to the declaration of a national emergency, which gave impetus to changes from the Centers for Medicare & Medicaid Services.
Hospital case management changed dramatically in the spring. Health systems began implementing far-reaching infection prevention measures and changed some operations to accommodate expected surges in patients with COVID-19. Social distancing is one of the most important ways to protect hospitals and public health, according to the Infectious Diseases Society of America.
Case managers and other nurses are coping with changes in operations, home life, and job descriptions during the COVID-19 pandemic. One of the more striking changes for case managers is the physical separation between them, their patients, and patients’ families.
COVID-19 has brought new challenges to discharge planning for elderly and seriously ill patients. Long-term care facilities still are accepting patients, but they will be in quarantine the first 14 days. The case manager should consider the patient’s needs before transfer to the facility.
In February, New York’s first COVID-19 cases were treated in Westchester County, a short train ride from Manhattan. With an analyst’s help, Westchester Medical Center worked bed optimization for the medical center’s 654 beds that included three COVID-19 patient care units: high-need intensive care unit beds, middle-need beds, and lower-need beds.
Case management and nursing were stressful jobs before the pandemic. Now, hospital nurses are facing unimagined stressors, all setting the stage for possible emotional crises and moral distress.
In this month’s Case Management Insider, we will continue our discussion of the essential skills RN case managers and social workers need. Last time, we discussed the case management process and the tools and techniques needed to be effective in assessing, planning, and managing patient care, utilization management, and discharge planning.
Relias is offering free, unlimited access to relevant resources to help healthcare professionals and individuals prepare and prevent the spread of infection. Click here to access these COVID-19 resources!
Financial Disclosure: Author Melinda Young, Author Jeanie Davis, Editor Jill Drachenberg, Editor Jonathan Springston, Editorial Group Manager Leslie Coplin, and Nurse Planner Toni Cesta, PhD, RN, FAAN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.
