I have been involved in some complex and challenging cases lately. As I reflect on my role, I realize that my role is mainly as a disruptor.

Yes, case managers are disrupters. We are in place to disrupt the status quo. If you have not experienced the healthcare system firsthand, it is fragmented, uncoordinated, complex, and sometimes downright mean, and it is getting worse.

I am writing this post to remind all case managers to take their roles seriously. You are needed now more than ever to be a disruptor!

The system is in trouble—not because the professionals who make up the system practice poorly, are poorly trained, or are uncaring. On the contrary, they are well-trained and caring, which is viewed as the main reason we are seeing burnout among so many healthcare professionals across all settings.

The issue is how the system is built. As Don Berwick said many years ago, the system is perfectly designed to achieve the results it is getting. Look at your outcomes. How are your systems performing? Look deep to discover the root cause of the challenges that cause you to come up short.

As a long-time nurse case manager and now Nurse Advocate, I act on problems when I find them. I try to improve communication, decrease fragmentation, and unite all stakeholders to create a coordinated and streamlined plan for my patients. This is time-consuming and takes a great deal of perseverance. Sometimes, it works, and things improve, but sometimes, I feel as though I am hitting brick walls.

Whether it is your role, we have to work together to humanize the system to work for all stakeholders.

I know our jobs are not easy. We are working with decreased resources and are pressed to move people through a complex and costly healthcare system that is not well.

The system works in silos. People sometimes don’t communicate, so as the saying goes, the right-hand does not know what the left hand is doing; even as case managers, we don’t use each other to transition our patients through the system.

One of our most important roles is to help improve communication between all stakeholders, including the injured worker and his/her family. Another is to educate and empower the consumer to speak up, ask questions, and know their role as a patient. Helping them set realistic expectations is so important that they realize how important it is for them to be involved. Improving these two areas would make a huge difference.

If you want a reminder about your role, I suggest you read the Case Management Standards of Practice. This is the one document everyone who calls themselves a case manager is responsible for upholding.

If you are called into a count of law, the attorneys will use the Standards of Practice to hold you accountable for your work and documentation. I hope you are never called into a court of law, but if you are, I want you to be prepared and know that these Standards exist and how they shape your role.

Reading Material on System

When a System is Not a System: https://deming.org/when-is-a-system-not-a-system

Healing Healthcare: https://healbrokenhealthcare.com (note I am a contributing author to this book)

3D Problem-Solving means listening, tearing down silos, and sending people home happy file:///C:/Users/Owner/Downloads/Article%20-%20UAB%20Reporter%20-%203D%20Problem-Solving%20%20(6).pdf

Dr. Don Berwick: Why is every system perfectly designed to get the results it gets? https://ihimedia.podbean.com/e/dr-don-berwick-why-every-system-is-perfectly-designed-to-get-the-results-it-gets

Case Management Standards of Practice: If you are a member of CMSA, you can download a copy for free. If you are not a member, you can purchase a copy  at https://cmsa.org/about/standards-of-case-management-practice

Case Managers are leaders in our healthcare system; I urge you to use your voice and work to be a disruptor! Don’t settle for a broken healthcare system for your patients or yourself. Work to make it better for all.

I hope you will take this post to your next staff meeting and discuss the challenges faced due to the broken healthcare system we all share. Remind them about their roles and the value they bring to the healthcare system and the people who use it!