The Professional Case Manager as a Change Agent Through the Use of Evidence-Based Practice
BY KATHLEEN FRASER, MSN, MHA, RN-BC, CCM, CRRN
“I have an almost complete disregard of precedent, and a faith in the possibility of something better. It irritates me to be told how things have always been done. I defy the tyranny of precedent. I go for anything new that might improve the past.” – Clara Barton
In this issue, themed around integrated case management, we discuss the important work being done through evidence-based practice (EBP). When we practice based on evidence, we integrate the individual case manager’s clinical expertise with the best available external clinical resources, while also taking into account the individual patient’s own values. This implementation into all aspects of the shared decision-making processes yield a full, comprehensive assessment and a subsequent professional case management service of care toward the goal of positive outcomes.
In the Professional Case Management journal, Suzanne Powell writes: “Evidence-based guidelines are becoming essential tools in the practice of case management. They serve as that valued resource that allows the individual case manager to be proactive in planning, educating the patient and the multidisciplinary team” (Powell and Commander, 2007). Evidence-based care management does not rely on opinions, but rather on actual evidence examination. Evidence enhances our practice by providing additional tools needed for the case manager to ensure the delivery of safe, quality care.
Unfortunately, case managers sometimes shy away from EPB utilization. Some of the excuses given include:
- Hard to access research articles
- Difficulty understanding interpreting, implementing into practice
- Too little time for research
- Lack of confidence in how to find the research findings needed
The failure to integrate the principles of EBP into our daily practice prevents our practice from moving forward as a profession. Utilization of EBP into integrated case management need not be difficult.
In order to utilize EBP, first ask yourself: What is an issue you need resolved? Then, put your research hat on and search online for related evidence applicable to your issue. Analyze the source as to its significance and analytical testing, and if that evidence supports practice change. If you and your team decide to utilize it, it can lead to valuable improvement initiatives not only for case managers, but for the organization as well.
Another way in which you can become more confident in your evidence-based practice is to arm yourself with formal training on integrated case management. Earlier in this issue, Becky Perez, CMSA National director of product development and education, highlights her integrated case management work with the Chinle Service Unit of the Navajo Nation in Arizona. In this example, we see how training healthcare professionals in evidence-based integrated case management is already making a difference for an entire nation.
If you and/or your team is interested in moving deeper into an integrated practice, please consider our newly envisioned Integrated Case Management program (www.cmsa.org/icm). The manual and program offer both the U.S. and the international scopes of ICM, as well as the integration of CMSA’s Standards of Practice for Case Management and CMAGs.
Through integrated and evidence-based practice, we can affect change. And, who better to be a change agent than a case manager? ■
Powell, S. K. & Commander, C. C. (January/February 2007). Editorial: A Tale of Two Initiatives: Case Management and Evidence-Based Practice. Retrieved from https://www.nursingcenter.com/pdfjournal?AID=692922&an=01269241-200701000-00001&Journal_ID=54025&Issue_ID=692921.
Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN, is a Registered Nurse, a Certified Case Manager, Certified Rehabilitation Registered Nurse and Board Certified in Case Management with the American Nurses Credentialing Center. She holds a Masters’ Degree in Nursing and also a Masters’ Degree in Health Care Administration.
Kathy served a two-year term as the National President of Case Management Society of America from 2014-2016 and currently serves as the Executive Director of CMSA.
In June 2016, Kathy was presented CMSA’s prestigious National Case Manager of the Year Award.