Case management consist of different disciplines in the care of a patient. I have interviewed a case management RN who works with the patient. I also interviewed another person only to have a different prospective of delivering care to a chronic pain patient during surgery. The other interviewee is an anesthesiologist that works at my ambulatory surgical center facility. Therefore, I have 2 people’s point of view of caring for a patient with chronic pain. One on a day to day basis and then another on the day of surgery.
The case management professional, I interviewed was N. Ledbetter, RN, BSN. She is a case manager for surgical inpatient Medicare patients at an acute hospital in Maine. N. Ledbetter has been a nurse for 16 years. She has been at the job for just over 1 year. She works with several other case managers in the department. The interview was conducted by phone. (N.Ledbetter, “personal communication”, October 17 & 18, 2016). Question #1- How are patients assigned to the Care Managers? The patients are assigned by units in the hospital. Discharge planners and utilization review are also involved with the patient. Question #2- How do you prepare for the patients? We use a system called EPIC and review the patient’s data. From the data I then prioritize based on admission hours/days. We also use another system for care management called MIDAS. Question #3- How often do you see the patients while in the hospital setting? It depends on the needs of the patient. More often if the patient is nearing discharge. Question #4- How do you handle the chronic pain population of patients? Prior to discharge the patients are referred to the pain management physician at the clinic. The physician will see the patient and make a plan prior to discharge. Question #5- Are the patient’s families involved at the beginning? The care manager incorporates a lot of the patient’s family involvement in the discharge needs. Question #6-How often are you involved with the physician of the patient? That depend on the patient and the diagnosis. The initial assignment of the patient and then as needed for updates. You are the primary worker on the patient’s care Question #7- Can you track or even ask the patient if the patients are getting medications from different physicians? In EPIC you can see who is prescribing the medications and which pharmacies are filling the prescriptions. Question #8-What other resources do you use? We also work with the utilization review team, discharge planning, social workers, rehab, and any clinics. We also incorporate the families input into the planning as well. Question #9- How is your documentation on the patient gathered and compiled? …show more content…
We use the computer system EPIC to write the notes and information on the patients.
Question #10- What happens when you start seeing several admissions by the patient? We take a look at what is happening to the patient and the surrounding circumstances leading to the admissions. We would see if the patient was compliant with the services provided. The next interviewee was Dr. Gregory Sheehan. Dr. Sheehan works for Spectrum Medical Group, which is Anesthesiology and Pain Management, located in South Portland. Dr. Sheehan is employed by Maine Medical Center. Dr. Sheehan did his medical school at Stoney Brook University Medical Center, and his residency at Dartmouth Hitchcock Medical Center. The interview was conducted face to face. (G.Sheehan, “personal communication”, October 17, 2016).
I did ask permission first if I could interview him with some questions about treating patients with chronic pain the day of surgery. I identified why I was asking the questions of him about chronic pain patients. Dr. Sheehan did say that he would answer the questions the best way that he could. Question #1- How you determine what to give the patient with chronic pain during surgery? Dr. S. stated “Make sure that the patient has taken their regular pain medication as prescribed on the day of surgery. This way we are not playing caught up with any narcotics”. Question #2 -What do you give in the case? “I then give any adjunct medications either preoperative or intraoperative to help the patient. Examples would be like Tylenol or Ketorolac”. Question #3-What amount of medications do you expect to give during the case? “I
The case management professional, I interviewed was N. Ledbetter, RN, BSN. She is a case manager for surgical inpatient Medicare patients at an acute hospital in Maine. N. Ledbetter has been a nurse for 16 years. She has been at the job for just over 1 year. She works with several other case managers in the department. The interview was conducted by phone. (N.Ledbetter, “personal communication”, October 17 & 18, 2016). Question #1- How are patients assigned to the Care Managers? The patients are assigned by units in the hospital. Discharge planners and utilization review are also involved with the patient. Question #2- How do you prepare for the patients? We use a system called EPIC and review the patient’s data. From the data I then prioritize based on admission hours/days. We also use another system for care management called MIDAS. Question #3- How often do you see the patients while in the hospital setting? It depends on the needs of the patient. More often if the patient is nearing discharge. Question #4- How do you handle the chronic pain population of patients? Prior to discharge the patients are referred to the pain management physician at the clinic. The physician will see the patient and make a plan prior to discharge. Question #5- Are the patient’s families involved at the beginning? The care manager incorporates a lot of the patient’s family involvement in the discharge needs. Question #6-How often are you involved with the physician of the patient? That depend on the patient and the diagnosis. The initial assignment of the patient and then as needed for updates. You are the primary worker on the patient’s care Question #7- Can you track or even ask the patient if the patients are getting medications from different physicians? In EPIC you can see who is prescribing the medications and which pharmacies are filling the prescriptions. Question #8-What other resources do you use? We also work with the utilization review team, discharge planning, social workers, rehab, and any clinics. We also incorporate the families input into the planning as well. Question #9- How is your documentation on the patient gathered and compiled? …show more content…
We use the computer system EPIC to write the notes and information on the patients.
Question #10- What happens when you start seeing several admissions by the patient? We take a look at what is happening to the patient and the surrounding circumstances leading to the admissions. We would see if the patient was compliant with the services provided. The next interviewee was Dr. Gregory Sheehan. Dr. Sheehan works for Spectrum Medical Group, which is Anesthesiology and Pain Management, located in South Portland. Dr. Sheehan is employed by Maine Medical Center. Dr. Sheehan did his medical school at Stoney Brook University Medical Center, and his residency at Dartmouth Hitchcock Medical Center. The interview was conducted face to face. (G.Sheehan, “personal communication”, October 17, 2016).
I did ask permission first if I could interview him with some questions about treating patients with chronic pain the day of surgery. I identified why I was asking the questions of him about chronic pain patients. Dr. Sheehan did say that he would answer the questions the best way that he could. Question #1- How you determine what to give the patient with chronic pain during surgery? Dr. S. stated “Make sure that the patient has taken their regular pain medication as prescribed on the day of surgery. This way we are not playing caught up with any narcotics”. Question #2 -What do you give in the case? “I then give any adjunct medications either preoperative or intraoperative to help the patient. Examples would be like Tylenol or Ketorolac”. Question #3-What amount of medications do you expect to give during the case? “I