10/2/2015 Case Management A Panel Presentation October 15, 2014 Panelists • Nicole Monroe- Scotland County Schools – Is in the implementation phase of case management – Focus is on getting started • Melanie Reese- Catawba County Schools – Participated in ECU research study and once it ended adapted case management tools and program to fit local needs – Focus is on diabetes care and new obesity initiative • Alice Luttman- Cabarrus Health Alliance – As a school nurse supervisor she developed policy – Focus is on moving from process to outcomes and then to impact Objectives • Identify similarities and differences between several case management programs • Identify tools that are available to assist in implementing a program • Commit to implementing at least one thing learned today to improve outcomes for students in your case load 1
10/2/2015 What is Case Management? • A nurse-managed program for students with chronic/complex health conditions based on intentionally planned contact with the student, family, teacher, and/or care provider and including a written plan of care that follows the nursing process. OR • Coordinating care among the school, home and community. History & Background • In 2002, a large LEA in NC began to do case management as a quality improvement initiative • In 2006 a formal research project was started in eastern North Carolina • Expanded the research project across the state 2008-2011 • Ongoing work is being done to encourage the adoption of a formalized case management program North Carolina Numbers NC Systems w/ CM Programs 54 of 115 LEAs reported having a formal CM Program Barriers listed if no program in Locally high nurse/student ratio place Lack of data collection system or plan Lack of someone to move a program forward Don’t understand the value of a program Number of students impacted Varies widely from nurse to nurse and system to system but numbers are growing. 2
10/2/2015 Positive Outcomes • For students: – Improved health & quality of life – Improved attendance & grades • For school nurses – Improved relationships with students and families – Improved professional satisfaction • For school health supervisors – Improved programmatic consistency – Increased data to support school nurse staffing Scotland County • Nicole Monroe- School Nurse RN, BSN nmonroe@scotland.k12.nc.us • In the first year of formalized case management process Catawba County • Melanie Reese RN BSN NCSN 828-320-7596 MelanieR@catawbacountync.gov • Has adapted tools and procedure for use in local school health program 3
10/2/2015 Getting Started • Develop an EAP, IHP and case management goals for your most frequently used careplans. (Diabetes, Asthma, Seizures) • Once you have mastered those, look at where you spend your most nursing time and add case management goals for those. (Pregnancy, lice, parasites, unsecured screening follow up, behavioral issues and medication compliance) Case management requirements in Catawba County Schools Case Management EAP IHP Goals Allergy X X Asthma X X Behavioral X Dental (dental follow X up) Diabetes X X Parasite (lice, X bedbugs) Pregnancy X Seizure X X Sensory (vision, X hearing follow up) Measuring improvement • 2013-14 SY- 185 students • 2014-15 SY- 212 students Each Nurse averages about 8-9 students a year in their case load. 4
10/2/2015 2015-16 SY BMI as a new case management focus area • NASN School Nurse Obesity Toolkit • Developed screening, monitoring and teaching from the tool kit. • 3 year outcome: 2014-15- Collected data for grades 1, 7, 9 2015-16- Case management for those with BMI >95% We will provide education and monitoring over the next 2 years. Cabarrus County Schools • Alice Luttman- RN, BSN, NCSN alice.luttman@cabarrushealth.org • Has implemented case management system wide and begun to use that outcomes data in presentations to community stakeholders for continued support for the school health program In conclusion… • Your Regional School Health Nurse Consultant has tools & resources to assist you in getting started. • Panelists contact information has been included for ongoing support. • Start where you are and take at least one step forward in implementing a more formalized program of care coordination. • Use the handout for good reference articles to use as you move forward. 5
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