The Rehabilitation Nurse as Case Manager
In a healthcare climate with skyrocketing costs for basic healthcare and increasing focus on managed care, the case management function is valuable to patients, employers, and insurance payers. This function requires well-prepared healthcare professionals with the knowledge and skills to navigate a complex healthcare environment. To achieve optimal effectiveness, today's case managers should be proactive practitioners who are cognizant of patients' needs and desired outcomes, concerns about cost containment, and the service options in the community. The rehabilitation nursing professional, acting as a gatekeeper for health services, an advocate for rehabilitation, and an expert on case management issues, is key to healthcare quality and cost containment.
It is the position of the Association of Rehabilitation Nurses (ARN) that rehabilitation nurses are the most qualified healthcare professionals to perform the case management function because they have the education, background, and expertise needed to coordinate patients' healthcare services from the onset of injury or illness to safe return to work or assimilation into the community as productive members of society.
To assist patients in achieving optimal outcomes, rehabilitation nursing professionals use their expertise in:
- effective communication between patient/family and rehabilitation team
- patient and family education to maximize rehabilitation process and minimize disability
- optimum utilization of therapies and community resources
- integration of psychosocial factors using disease management concepts
- the trajectory of illness and recovery for complex medical issues
- the care continuum over the life span
- healthcare resources
Rehabilitation nursing provides the foundation needed to practice the art and science of case management for patients with complex medical and psychosocial conditions. The nurse-patient relationship is unique within the healthcare environment and because nurses are central to the healing process, their role on the rehabilitation team is vital. Rehabilitation nurses use assessment skills in a holistic manner that is inclusive of physical, behavioral, spiritual, and psychosocial factors. From the first encounter with a patient in the case management process, rehabilitation nurses begin planning for discharge, using their communication skills within the clinical team to coordinate care, follow the patient through the rehabilitation process, and reinforce newly-learned skills to achieve maximum functionality.
As case managers, rehabilitation nurses are equipped to organize complex treatment plans and establish clear, attainable goals for the patient. Rehabilitation nurses educate not only patients but also patients' families; they provide the support and counseling that is central to the recovery process. As case managers, rehabilitation nurses use creativity, adaptability, and flexibility to enhance resources, maximize healthcare benefits, and seek solutions to achieve long term success.
ARN is the nursing organization that supports rehabilitation nurses and case managers by providing
- cutting-edge clinical education in patient management and disease management topics
- the foundation for best practice models that enable the case manager to assimilate and coordinate various treatment plans within an overall patient plan
- research articles in the Rehabilitation Nursing journal that can be immediately applied to the practice of case management
- information on navigating the healthcare system
- educational sessions and monthly updates on health policy, insurance, and funding issues that affect rehabilitation nurses and nurse case managers.
Approved January 7, 2005
Reviewed June 2006
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