title: Case management directors: how to manage in a transition-focused world: part 1.
abstract: OBJECTIVE
  Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the "moving parts" of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role.We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes.
  
  
  METHODS
  The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them.
  
  
  CONCLUSIONS
  Case management directors would benefit from further research and documentation of "best practices" related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another.
  
  
  CONCLUSIONS
  As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time.To operate most effectively, case management directors must understand the full range of their responsibilities and impact. They must find opportunities for themselves and their departments to learn and stay current as the regulatory environment continues to change. Providing a list of functions for which they are responsible, practical strategies for carrying them out, and places to go for help and information can help hospital case management directors operate with the confidence and knowledge they need to influence the quality and safety of patient care for the entire care team and to provide the best possible interactions with patients and family members.
authors: Cheri Bankston-White, RN, MSN, is Director of Clinical Advisory Services for Curaspan Health Group of Newton, MA. She has extensive clinical experience in health care, including case management, utilization review, home health care, and emergency department. Her primary area of interest includes transition workflow redesign and automation for hospitals, postacute providers, physicians, and software integration across multiple organizations. She can be reached at CBankston@Curaspan.com. Jackie Birmingham, RN, BSN, MS, CMAC, is VP, Emerita, Clinical Leadership for Curaspan Health Group of Newton, MA. She has extensive clinical experience in multiple settings with a focus on discharge planning and transition management. She has written several books and journal articles and has spoken nationally and internationally on the topic of case management across the continuum. She can be reached at JBirmingham@Curaspan.com.
authors: Cheri
authors: C
authors: Bankston-White
authors: Jackie
authors: J
authors: Birmingham
mesh_terms: D000288:Administrative Personnel; D019090:Case Management; D003266:Continuity of Patient Care; D004496:Education, Continuing; D006801:Humans
references: Jt Comm J Qual Patient Saf. 2011 Jan;37(1):29-36
references: 21306063
references: J Gen Intern Med. 2011 Apr;26(4):393-8
references: 21116868
references: Prof Case Manag. 2007 Jan-Feb;12(1):16-24; quiz 25-6
references: 17387287
references: J Gen Intern Med. 2014 Aug;29(8):1105-12
references: 24610308
references: Health Care Manag (Frederick). 2008 Jul-Sep;27(3):277-84
references: 18695408
references: Prof Case Manag. 2009 Nov-Dec;14(6):296-309; quiz 310-1
references: 19935347