After You Say Hello

How much thought do you put into how you introduce yourself to a new patient? If you're like most care managers - working at a breakneck pace most of the time - you probably make it up as you go.  But if you believe the old adage that you never get a second chance to make a first impression, you would do well to pay more attention to how you introduce yourself. 

The introduction is one of the most important elements of care management communication.  Most patients still don't understand the role the care manager plays in their care and misconceptions still tend to be the rule, not the exception. "I assist your doctor," is a frequent intro that we hear or "I'll be arranging your discharge." is another.  The care managers are just not thinking carefully about how the patient hears those words.  Off-the-cuff explanations like that get things off to a rocky start. But using a standard script to introduce yourself may go along way to reduce patient concerns and confusion. 

Care managers must assume that most patients have little experience working with someone who will be serving as their advocate to promote a safe, effective and timely progression-of-care.  You have to assume that patients are naive about what this means. And its not just the older patients who may be confused, but the younger patients as well.

While all members of the care team who go into a patient's room should introduce themselves, its even more important for care managers. The patient-centered care manager is still a relatively new role so its crucial that the patient and family understand that the care manager is working in partnership with every member of the care team to facilitate cost-effective care so that the patient is not at risk either clinically or financially. Patients with high deductibles will appreciate the help of someone who 'got their back' covered to avoid excessive testing or treatments that could safely be provided on an outpatient basis. And patients with frequent admissions for chronic care may also appreciate a referral to a palliative care associate to discuss future treatment options.  

In 30 seconds, introductory remarks should explain the care manager's partnership with the patient's care team to make sure that information is shared among every member of the team; that delivery of care will be expedited so that the patient can get home as quickly as possible; that if post acute care is recommended, options will be presented to the patient and family within 48 hours of admission; that prescribed care will dovetail into the hospital's commitment to quality improvement efforts, and that every effort will be made to make sure the care team hears, listens and responds to, the patient's preferences, concerns and questions.  

Standardizing the script saves time and generally leads to fewer questions down the road. While a script isn't intended to be memorized or read, having a basic narrative helps ensure that key messages make it into the conversation.  It serves as a foundation or outline of what should be covered during the care managers' initial encounter. The conversation should be followed-up with a brochure , which includes brief bios and pictures of the hospital's care management team and FAQs regarding the program.

Once the care managers develop the perfect introduction, consider the issue of what other care team members may be saying about you.  That's just as important because your colleagues are often a font of misinformation. In the old functional models, case managers were digging into charts doing utilization review or discharge planning and that may be all your team partners remember.  Value based, patient centered care managers are the new breed of patient advocates whose primary purpose is to make sure that the patients identified as needing care management will get the care they need, in the most appropriate setting and at the best cost.  If care coordination across the continuum is the ultimate goal of your hospital's program, it's best to start out on the right foot.