Why We Designed this Site
Real help in real time.
- One-hour courses (mostly)
- Available 24/7 on demand
- Go at your own pace, take courses you want
- CE's & Certificates available
ROSE'S STORY.
After eleven years as an oncology nurse in a large trauma center hospital in San Diego, I needed a change. The patients were getting younger (or maybe I was getting older) and it was becoming an emotional burden as many of the patients seemed to be closer to my age. As luck would have it, a discharge planner (this was 1994 - the department was called Discharge Planning) stopped by the nurses’ station on a Monday afternoon (I worked 3-11) and told me there was an opening in their department and she thought I would be really good at it. I got the manager’s name, interviewed on Wednesday, accepted the position by Friday and started the next Monday.
So there I was in a new position I had never done before. To be honest, I wasn’t even sure what they did. At that time I was mixing my own chemo on the unit, we kept patients forever it seemed. We did not see the discharge planner much. Let me describe the orientation process. It was one week. I was shown how to print a face sheet and place that behind the room number tab in my binder for the unit and how to feed the paper into the dot-matrix printer for the Med-Cal (Medicaid) TARs (Treatment Authorization Request). Then, how to print the TAR and put in a pile by unit and room number for the Med-Cal Field Nurse who would visit on Tuesday. Now on Tuesday if you discovered you had a Med-Cal patient after she had picked up the TARs that morning you had to go from unit to unit to find her and have her sign it. That’s about it. Oh, also given a list of resources and told to call others in the department if I had any questions. I shadowed another discharge planner for that one week. Did I mention I had two units (60 beds)? So that was it.
I basically learned as I went along. When a SNF would not accept a patient after I had spent what seemed like hours copying parts of the chart (pre- EMR) and faxing them out, then calling to see if they got the fax, oh, the face sheet did not go through? Re-faxing…. I would ask well why not? I thought I did everything right. Your patient is on a vent, we don’t accept patients on a vent. Try a sub-acute. (Had never heard of those.) As luck would have it I was assigned to the cardiac units - which had heart and kidney transplants as well as long term vent patients (plus cath lab and other complex cardiac/renal patients). I had a lot to learn and I learned a great deal from vendors and providers.
I have a Type A personality; I constantly push myself to learn more. I went on my own field trips to visit skilled nursing facilities, sub-acutes, dialysis units, LTACHs and acute rehab units. I asked a lot of questions. I am the type that does not like to say “I don’t know.” I wanted to be really proficient; I wanted to be the best. For the first 4 years (this was the mid to late 90’s) I kept my head down and learned all I could.
After a couple of years I asked to be taught UR (utilization review). That was done separately in our department. I followed around the best UR nurse and she was a great instructor. She talked in detail about what she was doing and what she looked for - then write in down in long hand on the back of the TAR or on a piece of paper from the copy machine then read it over the phone to the insurance representative. Bonus if we could just leave it on voice mail. That’s how I learned InterQual.
After 4 years I had been reading everything i could on discharge planning and UR and I asked the manager (we had 3 in 4 years) why our department was not called ‘Case Management?’ I could not get a good answer to that and I was getting to the point where I felt I needed to change to a different hospital to learn more. So I did and spent the next four years on just one cardiac unit (40 beds) learning so much more doing a combined discharge planning/UR model. I learned more about time management, metrics, length of stay and processes. In 2004 I moved into management of the department and that started a whole new learning process.
Once in management I could understand how difficult it is for a new case manager to really get a great orientation. There did not seem to be any time. We needed that person up and running on their unit. We would move a new person from staff to staff to lessen the burden on any one individual. It takes time to stop and explain everything you are doing. Later in my consulting work, I find this has not changed. This led me to create this site.
Case Management involves a very large body of knowledge. Like the bedside specialty areas it has its own lingo and specific knowledge base. There are state and federal regulations, if not followed could cause harm to the hospital. A discharge plan that is not safe can harm a patient. I love this field because it allows me to continue to work with patients, yet learn every day. As healthcare changes so does case management.
THESE COURSES ARE DESIGNED TO TACKLE INDIVIDUAL TOPICS FROM THE BASICS TO COMPLEX.
- I made a point to keep them short (most will be one hour).
- There are additional handouts with most of the courses.
- Take them in any order that you like
- The courses are available 24/7
- California Continuing Education (CE) credits are available for every course - the certificate will be emailed to you upon completion.
- Come back and retake the course for no extra charge.
- Reprint the handouts again.
- Get another copy of your certificate if you can’t find the first email.
Coming soon:
- CEs for other states and CCM certification
- SW courses and leadership courses
I hope you find these course helpful and they can supplement your orientation if you are new. One very important thing I have learned about Case Management - you will never have every answer and will constantly be learning. It’s OK to say ‘I don’t know.’ Find out the answer and share it. Case Management is a collaborative process.
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Instructor - Rose M. Turner
Here's what people have said about Rose:
"I've known Rose for over 15 years. She has always put her patients first by empowering them with good information. Rose has protected Scripps Health System and the Community through patient & systemwide education. Thank you Rose for all you've done and continue to do for the frail and elderly of San Diego!"
FAQ
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Do I have to take the courses in a particular order?
Not at all. You can take any course at any time.
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How do I get my CE certificate?
Once the course is complete, click on the CERTIFICATE button and it will automatically be sent to your email.
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If I have trouble with the site or any of the courses who do I contact?
Send any email to [email protected]. Happy to help.
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What's the difference between Case Management and Care Management?
Case Management and Care Management or Care Coordination are terms used interchangeably to describe Case Management. There are a number of books and professional organizations that have defined the difference but those vary greatly.
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What does the logo mean?
I am a quilter. I have often viewed case management as putting all the pieces together to create the best discharge plan for the patient. So the logo represents two aspects of my life.
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Where do your images come from?
All images on the site pages, courses and within the courses are stock photos. When looking at hospital specific stock photos they all seem the same, so we chose beautiful, colorful and interesting images. Most come from www.unsplash.com and are free.