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Published on: September 24, 2020
Acute Care Management During a Pandemic
Kelli Chovanec1,2, Nicole R Howard1,2
1Kelli Chovanec, DNP, RN, NE-BC, is the System Director for Care Navigation at ProMedica Health System, where she drives the care management strategy and model across the continuum of care with a focus on integration and population health management. Kelli provides strategic, operational, and thought leadership to support the organizational goals in the value-based health care environment. She is passionate about empowering nurses to work to the top of licensure to support patients in the self-management of oftentimes complex chronic conditions and serves as a systems expert regarding population health programs in various care settings. Kelli has 15 years of progressive nursing leadership experience in the areas of transitional and longitudinal care management, inpatient rehabilitation, and acute nursing. She earned a Bachelor of Science in Nursing degree from the University of Toledo in 2005, a Master of Science in Nursing degree in 2008, and a doctorate degree in Nursing Practice from Chamberlain University in 2020. Kelli is a Board Certified Nurse Executive through the American Nursing Association and a member of the Case Management Society of America.
Purpose/Objectives:
During the global pandemic of Covid-19, the hospital setting transitional care management was challenged by the complexities of the rapidly changing health care environment, requiring the implementation of an innovative approach to hospital discharge planning. The purpose of this article is to review the experiences of an integrated urban health system, exploring the strategic tactics to ensure effective communication between team members, patient and family engagement in discharge planning, establishing and maintaining trust, connecting patients to appropriate next level of care services, and providing transitional care management support.
Primary Practice Settings:
The Covid-19 pandemic response stimulated the rapid transformation of the acute care management model amidst the tremendous challenge of meeting the discharge planning needs of the hospitalized population in one large, urban, integrated health care system.
Findings/Conclusions:
Patients transitioning to the community setting following discharge are vulnerable and at risk for adverse sequelae, and transitional care management that does not end when the patient leaves the hospital setting is integral to promoting positive patient outcomes (Naylor, Aiken, Kurtzman, Olds, & Hirschman, 2011). The care management approach during the pandemic in one health care system precipitously shifted to an entirely virtual, remote model, and the team continued to provide transitional care support for hospitalized patients to avoid the common pitfalls that are associated with unfavorable outcomes.
Implications For Case Management Practice:
The insights gleaned from one health system's experiences during the pandemic are transferable to other facets of care management in routine circumstances, with emphasis on the avoidance of the common care management snares that lead to less than optimal patient outcomes. The development and implementation of multifaceted interventions, with the goals of supporting health-promoting behavior changes and self-care capacity for at risk populations, are relevant in the current health care environment.
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