Nursing leadership: new initiatives in case management

Abstract

Since July 1, 2003, Diane Huber has had the privilege of serving a 1-year term as chair of the Commission for Case Manager Certification (CCMC). The CCMC, which last year marked the tenth anniversary of its first certification examination, has certified more than 26,000 case management professionals from a variety of health care disciplines. As chair of the commission, Dr. Huber has worked closely with other commissioners on issues related to case management, a dynamic field that attracts many in the nursing profession. The other FAAN on the commission is Toni Cesta. Currently, the CCMC has 2 important projects underway. The first is a role and function study of case managers. The purpose of the study is to ensure that the Certified Case Manager (CCM) certification exam remains current with case management practice. The Role and Function project was launched in early 2004, and a pilot study is currently being completed. A full survey of case managers is expected to be sent out by the end of April or early May. The CCMC prides itself on its research-based certification. This has enabled the CCMC to become the first certifying body for case managers to be accredited by the National Commission for Certifying Agencies. The Utilization Review Accreditation Commission also has determined that the CCM credential is a recognized case management certification. The second project is the proposed revision of the CCMC's Code of Professional Conduct for Case Managers. The code, including standards, rules, procedures, and penalties, has been thoroughly reviewed in light of the many ethical issues facing case managers today. This is imperative given the changes in the practice areas for case managers. For example, a growing percentage of case managers are working in hospitals and other acute-care settings and facing complex practice situations. In January 2004, public comments on the proposed new draft of the Code of Professional Conduct were reviewed and additional changes were made. The full commission is expected to approve the proposed revised code at the CCMC annual meeting in mid-June 2004. Upon approval, the revised code will become effective later this year. The CCMC's Role and Function study and the revised Code of Professional Conduct reflect the commission's commitment to keep a finger on the pulse of change in case management. The field is being impacted by a number of factors, including spiraling health care costs, and a need for proactive strategies for risk identification and early intervention to prevent illness and to control future consumption of resources. Nurses working on the front lines of health care can use case and disease management as important interventions with both quality-of-care and health-policy implications. Case management is a vital strategy to further these causes because it seeks to advocate, coordinate care processes, control costs and allocate resources while ensuring that patients receive quality care that will return them to wellness and allow them to be productive while managing chronic conditions. Further, there is a growing awareness of the importance of disease management as a strategy to identify, assess, and address common health issues within a particular population (such as a group of employees). Case management can further enhance the effectiveness of disease management by providing individualized attention to individuals. Thus, as disease management identifies the needs of groups of individuals, such as those who have chronic conditions, case management seeks to provide access to timely and cost-effective treatment to return the patient to stability and improved wellness. In addition, the assessment and outcomes that are integral to case management help further the analysis of data used in disease management and related strategies. Case management will be an integral part of the effort among employers, insurers, hospitals, and other care providers to seek solutions to rein in health care cost increases while ensuring quality of care. The CCMC will continue to monitor these developments and the changes they bring to the case management field. In this way, the CCM certification remains current, and those who are certified can demonstrate they have the professional background, educational requirements, and the knowledge and skills that distinguish certified case managers. Case managers come from a variety of professional backgrounds. Although nurses comprise a large segment of the case management population, other professionals include social workers, mental health counselors, and physical and occupational therapists. In order to keep current with the field, the CCMC seeks the involvement of all professionals in the field. Further information can be found on the CCMC Web site (www.ccmcertification.org) or by contacting Diane Huber ([email protected]; 304 Olde Hickory Ridge, Coralville, IA 52241; 319-335-7122).