Case management has faced unprecedented challenges during the past year, which has seen it respond with positivity and agility to ensure service to its clients could be maintained. In the latest in our Q&A series, Sarah Cooke from Bush & Co shares her experiences, and how the newly-adopted telerehab will undoubtedly play a role going forward.
Can you summarise how the past few months have been for you
It’s certainly been the biggest challenge of my career! But I feel proud of how we have all pulled together, in whichever capacity we work with our clients, so they have been able to continue their rehabilitation.
How did you adapt to the restrictions of lockdown? Were you able to do this quickly or did it take a bit of time?
I adapted pretty quickly to the lockdown restrictions as I already worked remotely from home so my office space was set up. It was also normal to communicate with colleagues and clients by email and telephone. The strangest part was going from a quiet house to having my family at home either working from home or furloughed. I’m sure this affected the internet connection at times!
I think working within a supportive team has been really important. By supporting each other we have looked after each other’s well-being which, in turn, has enabled us to continue delivering a first class service to our clients. It is important to remember we are clinicians but also have personal lives and have been affected like everyone else.
At the beginning of lockdown the Bush & Co management team reacted quickly to the situation and put a Covid-19 risk assessment in place, supported us with increased communications and the relevant, latest guidance. This enabled me to decide how to complete Immediate Needs Assessments and reviews and ensured good communication with clients and stakeholders was maintained. We also put new initiatives in place quickly such as loaning out tablets to clients who had little or no access to technology. This meant Immediate Needs Assessments could be completed remotely but also meant ongoing case management could continue.
What have been the main challenges – were you able to overcome them?
Initially the access to PPE caused a challenge. However for those clients that the Covid-19 risk assessment identified still needed home visits, Bush & Co were able to provide PPE packs for each visit. I think social media also helped at this time as I received additional face masks from LinkedIn connections who shared what they could spare.
At the beginning of the pandemic we were faced with how to keep our clients’ rehabilitation going. NHS departments had closed and important surgery cancelled. Plus service providers needed to convert to new ways of working. My main focus was preventing clients from deteriorating and enabling them to maintain during this period. This was where the stakeholders stepped in and ensured funds where available to support our clients. For example, one of my clients’ pain had increased so the stakeholders funded an electric profiling bed to keep her at home and comfortable whilst she waits for surgery. Another example is how the pandemic has hit a lot of our clients psychologically. The stakeholders have secured funding for telephone or virtual treatment sessions.
Has the use of ’telerehab’ been of benefit to you?
Yes absolutely! It has enabled our teams to keep in touch with each other in a more personal way. I must admit to preferring to be able to see people rather than telephone conferencing. It feels a little bit more like a face-to face meeting. I definitely think the use of online technology has proved to be a real asset during the pandemic. Professionally I have used Zoom, Microsoft Teams and Air Meet. These platforms have been great for attending meetings and staying connected with colleagues. I’ve also had access to lunchtime yoga and mindfulness training delivered by Bush & Co and webinars kindly hosted by law firms.
How have your clients responded? Was it difficult for them to adapt to?
Most of my clients have been open to communicating via telerehab. One of the issues we have encountered is that they are often using mobile phones or tablets and their devices have been unable to open the meeting links to Zoom. Generally, my client group have preferred to use the camera feature on social media apps, such as, WhatsApp or speak over the telephone.
If face-to-face contact has been identified as needed by the risk assessment and it’s been clinically safe and appropriate to meet in person, I have continued to visit clients so this has avoided causing any damage. I must say I have certainly missed seeing my colleagues in person but don’t think it has been damaging because we have used the virtual resources. Bush & Co has introduced ‘Happy Post’ so we’ve been connecting through good old fashioned letterbox mail as well as electronic ‘Postcards from Home’ which have been a way to see how other people’s lives have changed during the pandemic.
How central do you think the use of telerehab will be for you going forward?
I think telerehab will change our working practices and we will attend more virtual team meetings, multi-disciplinary team meetings, webinars and training sessions etc. Moving forward I will definitely consider telerehab for my clients but I don’t think it is a replacement for face-to-face client visits because of the nature of our work. I think a blended work approach is definitely the way forward.
How do you think the future of case management has been shaped by the pandemic?
I think there is a much better understanding of what home working is; the challenges, opportunities, limitations and rewards that it brings. Pre-pandemic I would use telephone or face to face client contact. The pandemic has made us aware of a third option – telerehab. It’s also opened up access to new providers of therapies and rehabilitation which would have normally been restricted due to distance from the client.
Will you be doing anything differently within your business going forward compared to pre-pandemic?
I have learnt during the pandemic the importance of physical contact with my clients. This is something I have probably taken for granted throughout my career. Some clients need this more than others, for example, because of lack of IT skills or cognitive impairment. There are clients though that engage really well using telerehab so moving forward I will definitely be embracing a blending working approach. Ultimately the clients’ needs have always been at the heart of the decisions we make and so going forward we’ll be taking our learnings forward in terms of telerehab needs too. Our clients are often vulnerable and may be anxious or reluctant to get back to ‘normal’ so we won’t be rushing.
New chair of BABICM appointed
A new chair has been appointed by the British Association of Brain Injury and Complex Case Management (BABICM).
Vicki Gilman has taken over at the helm of BABICM, which is the representative body for continued professional advancement of case management and promotes best practice in supporting people with brain injury and complex conditions.
She takes over from Angela Kerr, who steps down after five years in the role at the helm, in what is BABICM’s 25th anniversary year.
“I’m delighted to be BABICM’s new chair in our 25th anniversary year. The organisation has a well-established, powerful and influential voice and we will continue to ensure that the needs of people with brain injury and complex medical conditions are recognised and met,” says Vicki.
An experienced case manager, health entrepreneur and clinical specialist neurophysiotherapist, Vicki is currently managing director of Social Return Case Management, a company she established over six years ago.
She qualified in physiotherapy at King’s College, London and completed a Master of Science degree in neurorehabilitation at Brunel University.
For several years, Vicki worked in a specialised military neurorehabilitation unit, treating adults with brain injury, spinal cord injury, and other complex conditions.
Vicki coordinated and worked clinically in NHS and independent sector multidisciplinary community teams treating people with neurological conditions, and she was an expert witness in brain and spinal cord injury for over 20 years.
Her work in a multidisciplinary team steered her into case management, and for six years Vicki was on the BABICM Council and chaired its training events group, returning last year to BABICM Council for a preparatory year before stepping into the role as chair.
“These are challenging and changing times for everyone in healthcare and beyond,” continues Vicki.
“As case managers we need to be flexible but quick to respond to new developments and ways of working, ensuring the best possible outcomes for our clients.
“As an organisation, BABICM has to be responsive to the needs of our members; we must ensure that they receive the training and support required to maintain our high professional standards and to deliver best-practice services.”
Awards to recognise role of case management during pandemic
An awards event is being held to recognise and reward the role of case management during the COVID-19 pandemic.
CMSUK is holding its first-ever virtual awards event, which will bring together industry professionals from across the country to reflect on the impact of the pandemic on case management practice.
The ‘Acknowledgement of Achievement Awards; How the Pandemic Has Changed Case Management Practice’ event has four categories which will allow case managers and businesses the opportunity to review their work and achievements.
The event, on Friday, September 24, will build further on CMSUK’s commitment to case managers during the past year, during which it delivered a comprehensive offering in online education through an array of lunchtime webinars and study days, culminating in the industry’s first online conference.
Education and development is currently more vital than ever in case management, with the upcoming launch of the Institute of Registered Case Managers (IRCM) requiring case managers to evaluate heir learning and experiences to shape their professional development and practice.
“We didn’t have an awards event last year, and while we wanted to do something this year, the board felt we needed to do something a bit different,” Niccola Irwin, director of CMSUK, tells NR Times.
“This will be an opportunity to reflect on how COVID-19 has changed case management. In the submissions, we are asking for reflection on how the pandemic has changed their practice, which will also allow for sharing and showcasing good practice.
“Case managers have always been very creative and tenacious, and those strengths were never more needed than when the pandemic came and the circumstances were very different. But I think through reflecting on that time, looking at what we did and what we could do differently, will result in an even stronger offering to clients, customers and staff.
“The awards this year have been pared back a little bit, we have four categories, but we are so pleased to be able to reflect on the past year in this way, in what we hope will be a very nice event as well as a chance to celebrate.”
Categories open for nomination are:
- Clinical Case Manager of the Year – Catastrophic
- Clinical Case Manager of the Year – Moderate/Severe
- Case Manager Supporter of the Year
- Case Management Company of the Year
Shortlisted nominees will be invited to present their short reflection at the online networking and award event.
Visit CMSUK here to find out how to nominate, sponsor the awards and book a place at the event. Nominations close on Friday, June 25.
Case managers praised for vital work during pandemic
Case managers have won praise for the “vital role” they have played in their response to the COVID-19 pandemic.
New research has found that 81 per cent of claimant personal injury solicitors believe case managers have risen to the challenges presented by the pandemic.
Solicitors credited case managers for “adapting to an unprecedented situation”, “transitioning to remote working”, “developing bespoke solutions”, “ensuring rehabilitation continued seamlessly” and “facilitating remote rehabilitation”.
The research, by barristers Exchange Chambers and neurorehabilitation centre Calvert Reconnections – a first-of-its-kind brain injury rehabilitation centre in the UK, which opens next month – reflects on a period during which case management had to find alternative ways to provide its services to clients to ensure support continued.
“This research is well-deserved recognition for the vital role case managers have played during the Covid-19 pandemic. They’ve worked proactively and innovatively to ensure the most effective outcome for their clients,” says Bill Braithwaite QC, head of Exchange Chambers and a trustee at the Lake District Calvert Trust.
Calling for ever closer working relationships between lawyers and case managers, Bill added: “I’ve always thought that a good case manager was the key to a successful outcome for the injured person, the family, and the compensation claim.
“If you appoint a good case manager early, and that person has the ability to get to know the family, gain their trust and confidence, and help to manage the stormy voyage through recovery and rehabilitation, that person will be an invaluable contact point for the solicitor, frequently helping him or her to avoid disturbing and distressing the family.
“So much of the litigation is bound up with the injured person and the family, and the plan for life.
“Further developing the relationship between the two professions would inevitably improve standards all round.”
Heather Batey, neuro OT, managing director of reach and trustee at The Lake District Calvert Trust, spoke of the vital role case managers have played in supporting clients.
“Over the past 12 months, the health and wellbeing of many TBI patients has been in the hands of case managers who have been supporting their patients and sourcing services as required while being the ‘go to’ point for families,” she says.
“Throughout the pandemic, it has been a difficult role to navigate, but by using their clinical reasoning skills and thinking ‘outside the box’ in such extraordinary circumstances, they have successfully ensured that treatment has progressed, generally remotely.
“They’ve also supported their patients’ mental health, which has been paramount.
“Case managers have also been excellent in sourcing iPads, laptops and smart phones for their patients, which has enabled rehabilitation to progress successfully.
“I totally agree that a good case manager is key to ensuring a successful outcome for a TBI client and their family. I work with case managers and with almost every patient we have seen excellent practice, great communication and holistic problem-solving skills coming to the fore.”
Jackie Dean, clinical director at N-Able Services, also welcomed the findings.
“It is my experience that case managers have advocated for their clients, have ensured that services have continued, both remotely and in person where required, and with appropriate PPE,” she adds.
“Risk assessments have been conducted and, as is the strength of case management, problem solving has taken place around staffing, mental capacity and continuation of therapy in the community.”
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