The case management concept has been around for decades now, but until the last few years it wasn’t on the top of the average C-suiter’s priority list. However, with hospitals now being penalized for excessive readmissions for key conditions, including COPD, that has changed big time, and respiratory therapists should be the logical choice to serve as case managers for patients with chronic respiratory disease.
Are we there yet? We asked AARC Continuing Care/Rehabilitation Section Chair Krystal Craddock, BSRC, RRT-NPS, herself a COPD case manager at UC Davis Medical Center in Sacramento, CA, to give us a status report —
Federal penalties for excessive COPD readmissions are driving hospitals to pay more attention to COPD case management. Why do you believe the respiratory therapist is right for the job?
RTs are the bedside clinical experts on pulmonary diseases, including COPD. After two years of intense respiratory training to complete an AS, and many with four years completing their BSRC, no other licensed clinician has more knowledge of disease pathophysiology, medications, equipment, diagnostics, and treatments for COPD than an RT. At the bedside, we have seen COPD patients struggle with medication delivery devices, confusion over equipment, and difficulty breathing. We are able to empathize with our COPD patients, make the necessary recommendations, and educate these patients from the experiences we have had in the field of respiratory care. As RTs, we have learned so much from our COPD patients, and they continue to teach us every day.
You are part of a successful COPD case management program there at UC Davis that has been used as a model for other hospitals seeking to set up similar programs. What do you believe other hospitals can learn from your experiences using RTs as key members of the COPD case management team?
Our program is truly interdisciplinary, with RTs leading the case management of these COPD patients. Education of patients on management of their disease, without judgement and with great empathy, is essential. It is important as an RT COPD case manager to stay up-to-date on current treatments, medical equipment, insurance coverage, and resources available to our patients.
It is also important to remember that not one COPD patient is like another. The care of a COPD patient must be individualized, and working on an interdisciplinary team with physicians, pharmacists, and nurses to make that happen is key.
What have you learned about the status of RTs in COPD case management programs across the nation from your role at UC Davis and your position as chair of the section? Are you seeing more hospitals set up programs similar to yours?
We have been thrilled to see programs modeled after ours at UC Davis, but have seen that these health systems also realize that it is not a “one size fits all” model — the same as treating a COPD patient! Programs have not reinvented the wheel, but have molded our COPD case management program to fit their hospitals and their patient population, which is important for a successful program.
What do RTs need to do to position themselves for further success in the COPD case management arena?
As RT COPD case managers, we are continuing to further our education and adjust to ever-changing health care. To be successful in COPD case management, RTs need to always have compassion and empathy for our patients and colleagues. We need to stay one step ahead with medications, treatments, and insurance guidelines in order to make proper recommendations for our patients without increasing hospital length of stay.
We do this by utilizing the knowledge and resources of our friendly pharmaceutical and equipment representatives and making friends with our DME companies. Showing other disciplines our necessary position in the education and case management of COPD patients will continue to prove our worth in this specialty role.
Looking to up your COPD case management skills or get up in the game? Check out these AARC continuing education courses to help get you started!