title: Case management directors: how to manage in a transition-focused world: part 2.
abstract: OBJECTIVE
  Case management directors are in a dynamic position to affect the transition of care of 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.This is Part 2 of a two-part article written for case management directors, particularly new ones.Part 1 covered the first 4 of 7 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.This article attempts to answer the following questions:
  
  
  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 (CMs) reporting to them.
  
  
  CONCLUSIONS
  Part 1 found that 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. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations that include payer, provider, and regulatory agencies. At the same time, they must also develop the skills to positively influence the revenue cycle and financial health of both the organization for which they work and those to whom they transition patients.
  
  
  CONCLUSIONS
  A director of case management with responsibility for transitions of care has more power and influence over patient safety than is commonly known. Few of the directors who are drawn from clinical case management or other leadership positions and thrust into this role are prepared to navigate within the organization, much less across the whole spectrum of payer, provider, and monitoring organizations. Yet the external focus of the director's role continues to grow in importance as the health care industry evolves and more focus is placed on population management and relationships with payers and community providers.
authors.affiliation: 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 is in 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.forename: Cheri
authors.initials: C
authors.lastname: Bankston White
authors.forename: Jackie
authors.initials: J
authors.lastname: Birmingham
mesh_terms: D000068:Accreditation; D019090:Case Management; D019468:Disease Management; D006740:Hospital Administrators; D006801:Humans; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D000069341:Transitional Care / Q000592:standards