Case Management
“Case Management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet a patient and their families’ health needs through communication and available resources to promote quality cost-effective outcomes.” – cmsa.org
Case Management Department Staff
(From right to left:)
Molly Bearden, RD, LD – Diabetes Educator
Gloria Robertshaw, LISW – Behavioral Health Consultant
Kathy Wolf, RN, CHPN – Case Manager
Catherine Logue, RN, CCM - Case Manager
Yevonn Archuleta – Administrative Assistant
Sandy Whitney, RN, CCM, ACM – Department Director
Not pictured: Sandy Thiese, RN, BS,CCM, CRRN, CNLCP – Case Manager
Scope of Services:
- Performance and Outcomes Management
- Advocacy and Education
- Clinical Care Coordination/Facilitation
- Psychosocial Management
- Continuity/Transition Management
- Utilization Management
At Holy Cross Hospital, the Case Management Department is staffed with professional health care providers who facilitate a collaborative model to include the patient/family, nurse, physician, other practitioners and resources within the community. The goals of the Case Management Department include the achievement of optimal health, access to care and appropriate utilization of resources, balanced with the patient’s right to self-determination.
Case Management serves as a means for achieving patient wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The Case Manager helps identify appropriate providers and facilities care throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the patient and the reimbursement source.
The Case Management Department works on behalf of the patient while they are in the Hospital by coordinating departmental and medical services. In addition, Case Management helps patients and families connect with appropriate community resources and support services for when they are ready for discharge.
Making Medical Choices: Your Right to Decide
Many people today are concerned about such questions as:
- Can I accept or refuse medical treatment based on my own values, preferences or beliefs?
- Who will make medical choices for me when I am not able to do so for myself?
- Will the wishes for my medical care at the end of my life be honored?
An “Advance Directive” is a written document signed by the patient that states the patient’s wishes, desires and decisions regarding medical treatment and includes, but is not limited to a Living Will, Durable Power of Attorney, Christian Affirmation of Faith, a document purporting a Living Will or Durable Power of Attorney not properly executed or other similar document.
“Medical Treatment Decisions” means decisions of what treatments, including but not limited to: IV hydration, IV nutrition, ventilators or other artificial means of respiration, any resuscitation procedures, the administering of antibiotics, stimulants or other drugs, that shall, or shall not, be used on the patient.
During your admission process, you will be asked if you have an Advance Directive. If you have an Advance Directive, please provide us with a copy for your Hospital medical records. If you do not, you may ask your Nurse or call Case Management at 575-751-5808 for the document.
- To Visit the American Hospital Association website: click here
- For an Advance Directives Brochure: click here
- For a New Mexico Advance Directive Planning Document and Forms: click here
- For a Living Will Wallet ID Card: click here
Inpatient Diabetes Case Management Program
Holy Cross Hospital is finding new ways to help diabetes patients in the Hospital and after they return home. Linda Buckingham, RN, Diabetes Care Manager is a clinical advocate who works closely with the diabetes patients and their family members along with physicians and other clinical staff to identify and resolve issues including diet, getting to and from doctor visits and having access to the proper medications and equipment. She also places follow-up calls to patients with diabetes after they return home from the Hospital to assist in self-directed care.
Inpatient Diabetes Demonstration Project: New Program Now Offering Intensive Diabetes Education To Hospital Patients
Holy Cross Hospital was one of 14 rural hospital sites in the nation that was awarded a five-year CMS Demonstration Project (Centers for Medicare and Medicaid Services). The Demonstration Project was presented as an opportunity for Holy Cross Hospital to implement a program to address the diabetes epidemic in the Taos area.
Holy Cross Hospital’s goal for the Demonstration Project was the development and implementation of the diabetes Case Management Program, which would be housed within the HCH Case Management Department to provide for a more comprehensive evaluation and quality discharge for all in-patients with a diagnosis of diabetes.
In addition to identifying and assessing in-patients with diabetes, the diabetes Case Manager’s daily approach includes; providing diabetes education to patient/caregiver; systematically coordinating appropriate services and promoting use of community and regional resources; obtaining diabetes supplies/equipment as needed; encouraging and promoting patient empowerment; self-directed care, self-advocacy, and the ability to make informed health care decisions.
The overarching goal of the Demonstration Project at Holy Cross Hospital is to provide education, resources and follow-up to prevent or delay the complications associated with diabetes, which include heart attack and stroke, kidney damage, blindness, and amputations.
A specific enhancement of the Demonstration Project is the increased collaboration between the Outpatient Diabetes Education Program (HCH Diabetes Self-Management Program) and the new HCH Diabetes Case Management Program. This enhancement would formalize the referral structure between inpatient and outpatient diabetes education services, which would ultimately result in fewer hospital admissions related to diabetes. This would bring an overall reduction in the number and severity of complications of diabetes.
For additional information about the Case Management Department at Holy Cross Hospital, please contact Sandy Whitney, Director of Case Management at 575-751-5794.
For information about the Inpatient Diabetes Case Management Program, contact Linda Buckingham, RN, Diabetes Care Manager at 575-737-3285. |