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ForwardFoundations of Case Management: A Patient-Centered Approach (IHP)
Welcome to Case Management, an online self-paced course developed and sponsored by the MGH Institute of Health Professions Office of Continuing and Professional Development.
This learning experience is designed for people who are engaged in healthcare delivery at the nexus of patient care needs and the complex world of healthcare reimbursement. Whether you are a licensed healthcare professional whose future career trajectory is in case management, or an employee newly supporting a healthcare management team, this course is dedicated to developing people who are invested in supporting patients and families through an in-depth understanding of the complexity of healthcare delivery and reimbursement.
What will I learn?
- The most important goal of this course is to provide case management knowledge and practical skills that are essential to improving healthcare delivery and outcomes for individual patients and their families. You will learn about health insurance and reimbursement requirements, and strategies for accessing available benefits to improve healthcare.
- A second goal of this course supports the first goal, and that is to foster a broad understanding of complex healthcare delivery systems as they impact patients' access to services and transitions of care.
- Finally, a third goal of this course is to demonstrate how to use knowledge and skills to support patient care and outcomes in a manner that is optimal, efficient, and also decreases the overall cost of care delivery.
You may be a nurse involved in direct patient care, taking this course in pursuit of case management skills. As a nurse, you really know when you have connected with a patient, when you have been off for a few days and come back to work, and your patient looks up at you and says, “It is so good to have you back!” This course will help you expand on those skills of connecting with patients, beyond one-on-one bedside care, through new knowledge about healthcare delivery systems, reimbursement insurances, and options for care.
Alternatively, you may be a licensed provider in another profession, such as social work or therapy, planning to adapt or expand your skills within your current work or in response to changes in your healthcare organization. Lastly, you may be taking this course to embark on a career in healthcare through knowledge of care delivery and reimbursement systems and skills that support a team of healthcare providers, including case managers.
This course material is designed to support learners who are licensed providers and new employees. It has been developed by an interprofessional team of case managers, licensed social workers, physicians, nurses, physical therapists, occupational therapists, and healthcare administrators. This interprofessional design is intentional and reflects the fact that case managers have a significant and active role within an interdisciplinary healthcare team, one that places the patient at the center of the team's function.
Two Notes
- This course does not engage in the national debate about how to provide health insurance to United States citizens. It is designed to help you understand what it means to have insurance, how to access insurance benefits, and what you can do to assist patients without health insurance.
- In different care environments, the term “patient” may be used, but often a person may be referred to as a “client.” For ease of reading, the course will use the term "patient".
Christine Dutkiewicz, RN, BSN, MSN, CCM
Chris has been a registered nurse for over 40 years. She received her BSN from the State College at Brockport, NY, and her MSN from Boston University. She has been a certified case manager for over 15 years.
As a newly licensed RN, Chris started at Beth Israel Hospital in Boston when Primary Nursing was first introduced in providing individual care to assigned patients on a medical unit. She later became a Unit Teacher for a 44-bed medical unit.
Chris then moved to Brigham and Women’s Hospital where she was Nurse in Charge on an Orthopedic unit for several years. She then transferred to a 30-bed medical unit as Nurse in Charge and later as Nurse Manager.
It was on this unit where the first Physician Order Entry programs were tested. Also in this unit, she had her first exposure to case management when working with Harvard Community Health Plan and their unit-based case managers.
As a nurse when admitting a patient to her medical unit, she would always assess her patients in wanting to know who that person was, who were their supports, where did they live and would they be able to return to their home.
When hospital case management programs were started in 1990’s, Chris was hired as the Orthopedic Case Manager at Brigham and Women’s. As the Orthopedic Case Manager, she developed a teaching guide for Total Joint Replacement patients as well as started a Joint Class with an interdisciplinary team.
She later became the Care Coordination Manager for Surgery and Orthopedics, then Program Manager for Utilization and then led the RN Care Coordinators as the Nursing Director for Care Coordination. As Nursing Director, she teamed with the RN Care Coordinators who covered every inpatient unit in the 877-bed hospital and with the ED Care Facilitators who covered the Emergency Department patients.
Chris has received many awards at Brigham and Women’s: Dennis Thompson Award, Partners in Excellence and multiple Partners in Excellence Team Awards.
Chris is a member of the Case Management Society of America and the American Case Management Association.
Course Contributors
Shaune Barry, BS, MBA
Vice President, Referral Operations & Business Development
Mass General Brigham
Martha B. Burke, MSW, LICSW
Former Director of Social Work in the Care Coordination Department
Brigham & Women’s Hospital
Barbara Collishaw, RN, MSN, CCM
Former Assistant Nursing Director for Care Coordination
Brigham & Women’s Hospital
Susan E. Farrell, MD, EdM
Director of Continuing Professional Development
MGH Institute of Health Professions
Emergency Physician
Brigham & Women’s Hospital
Sharon Fawcett, LICSW
Manager of Case Management
Spaulding Rehabilitation Hospital
Carol Gleason, MM, RN, CRRN, CCM, LRC
Named Case Manager of the Year (2007-2008) by the Case Management Society of New England
Mary Moffat PhD, RN
Former Manager in Care Coordination
Brigham & Women’s Hospital