Catastrophic Case Management

Commission for Case Manager Certification (CCMC)
Full article on ccmcertification.org
By: Michelle Baker, BS, RN, CRRN, CCM WCCM N0273, Director, Clinical Resource Operations, Paradigm

Case management always involves putting patients first, organizing sometimes complex systems of care, and orchestrating clear communication among numerous parties. When it comes to catastrophic case management, all of those things are part of the process, but the patients are those living with severe, often life-altering injuries, multiple comorbidities, and permanent disabilities. Due to this, work in catastrophic care must also address behavioral health concerns, as extensive injuries of this nature present psychosocial implications.

As a result of this intensive web of care needs, the work of a catastrophic care case manager is varied, interesting, and extremely engaging.

The Life of a Catastrophic Care Case Manager
After beginning her career in an inpatient setting, Michelle Baker, BS, RN, CRRN, CCM WCCM N0273, Director, Clinical Resource Operations, Paradigm, and a former Chair of the Commission for Case Manager Certification (CCMC®), was recruited to provide field case management. It was the ideal decision for her.

“The feeling of being able to coordinate services and treatment for someone in a desperate situation was all it took — I was hooked. Being able to essentially provide what is medically necessary for a patient to get them back to the most independent status possible is very rewarding,” Baker said. “Anyone who is looking for a challenge and is seeking a fresh start in case management, catastrophic field case management is a very interesting and rewarding path to consider.”

Working with the population of patients who have experienced catastrophic injuries is particularly demanding. However, that level of intensity serves to bring treatment providers together as they strive toward the same goal.

“This population needs every treatment that is recommended, given the serious nature of their injuries,” Baker said. “This makes for a more collaborative relationship with treatment providers, given that we are all working toward getting the patient to the least restrictive, most independent state possible.”

That isn’t to say that there are never any difficulties with securing the necessary care or that there is never any resistance from colleagues. But when such situations arise, the knowledge that you are working on behalf of your patient helps guide you to negotiating a resolution that will serve their needs.

“When someone doesn’t understand the catastrophic nature of an injury and doesn’t appreciate the needs a patient may have, I challenged myself to educate them on expectations, the longevity of residual injury characteristics, and how beneficial it is to have a field case manager to assist the patient in navigating the healthcare arena and ensure all their needs are met,” Baker said. “I always viewed this as an opportunity to be a true advocate.”

That advocacy is just one aspect of the work of a catastrophic care case manager. The cornerstone of catastrophic care is building trusting relationships with your clients and their families and providers. In this field, critical thinking skills are highly valued. Medical providers can be extremely compartmentalized, and you always need to be one step ahead to ensure that your clients are on track with their care — and that no critical areas are being overlooked.

Baker often worked with clients for long periods; the time lapsed from the date of her clients’ injuries through their rehabilitation to the most independent state possible is, on average, 18 to 24 months. And because people who have suffered extreme trauma require care from a network of medical providers within numerous specialties, every day on the job brings something new.

“Making a difference in someone’s life is what makes this such stimulating and challenging work, which is what made me strive to do more. I just wanted to do everything I could to assist patients with restoring some normalcy in their lives,” Baker said.

How Being a Certified Case Manager (CCM®) Helps in Catastrophic Care
Regardless of your specialty area, being certified improves your work, your career, and your patients’ outcomes. This is just as true in catastrophic care as it is in any other field. Being a CCM signifies to your colleagues in the healthcare field that you have taken the time to learn as much as possible about case management, bringing value to your organization and your patients.

The continuing education (CE) credits that are required to maintain your CCM also signify your willingness to learn and grow. Beyond that, they broaden your scope of knowledge, giving you confidence in your work as a case manager.

“I have always been proud to be a CCM, and my certification gave me credibility when meeting others in the field, at hospitals, and at physicians’ offices,” Baker said. “Obtaining CE credits helps me keep abreast of new clinical, psychosocial, and other healthcare issues affecting the overall settings, in addition to advancing my knowledge.”