I recently had the opportunity to experience patient care from the vantage point of a hospital bed when, as a newly diagnosed breast cancer patient, I experienced a series of adverse reactions following my first round of chemotherapy. I spent seven long days in the hospital.
When it was finally time for me be discharged, I had strong concerns, as a professional case manager and registered respiratory therapist, about how my ongoing recovery would continue following my transition to home. I live alone: was I going to need home health or aid and attendance? Were all of my medications being ordered for me at my local pharmacy? Were follow-up appointments scheduled with my physicians?
I wanted to be sure that nothing was overlooked before I left the hospital, because I knew it would be difficult to get the help I needed once I was back at home. I was still not in any physical or mental condition to initiate several phone calls or jump in the car for a run to the local pharmacy.
What I experienced was quite telling. First of all, I might never have met my case manager if I had not specifically requested a meeting with her. And once I did meet her, it was clear that she had not planned to involve me in my own Plan of Care. She seemed taken aback by my questions, and did nothing to allay my concerns. Most importantly, she did not assist with follow-up appointments, instead telling me I would have to make those calls myself. Nor did she ensure that all of my medications were waiting to be picked up at my local pharmacy. She did not provide me with instructions or present me with the discharge paperwork that I needed to sign.
What did she do, exactly? I am still not sure. Was my experience unique? I am not sure about that, either.
Having worked in the Durable Medical Equipment (DME) industry for several years, I can attest to the fact that many of our respiratory patients go home from the hospital without some or all of the equipment and supplies they need in order for their care to continue seamlessly at home. I became a Respiratory Case Manager because I wanted to help alleviate that problem.
But I was not a respiratory patient—my issue was of a general medical nature. Yet the problem was the same: I did not get the support from my case manager that I needed to ensure a seamless transition from hospital to home.
Case Managers are a proud breed, and we work very, very hard. My experience suggests that despite all of our hard work, we are still missing something. And that something is connected to the very things we seek to achieve: Seamless coordination of care, uninterrupted recovery, and the satisfaction of our patients and their families.