Coordinating Inpatient Care for Medically Complex Patients
A 75-year-old man has a hip replacement. It's a straightforward procedure. But the patient has diabetes and heart disease, so the risk of complication is high. But if the patient has a care manager, chances are good that surgery will be successful and recovery uneventful.
Promoting Quality Care
"Most of our patients are medically complex," says Sandy Hilliker, director of nursing operations for care management at Fairview Southdale Hospital. "Our job is to see the big picture so we can promote quality care that is also cost effective."
Hospital care managers work collaboratively with the patient, the family and the physician to create a plan of care and ensure that it is carried out. Other members of the team include social workers, nurses, and various health and community service providers.
Managing a Hip Replacement
When a medically complex patient needs a hip replacement, the care manager becomes involved immediately after the procedure. The manager reviews the patient's records and then, working with the physician, patient and family, develops the plan of care.
During the hospitalization, the care manager watches the patient closely, sees that necessary tests are done promptly and checks the results to ensure that medications are correctly adjusted. The manager collaborates with the physician to address any special needs stemming from other medical conditions like diabetes or heart disease.
