By Alan Boardman LMSW; ACM-SW

Kaiser Permanente of Washington received the 2023 Practice Improvement Award 2023 from the CMSA Foundation for their Virtual Inpatient Case Management Program. This program achieved impressive results in conducting transition of care activities during the COVID-19 pandemic. Through thoughtful adaptation, Kaiser Permanente quickly deployed a telephonic model to facilitate comprehensive care coordination activities that prevented rehospitalizations during the pandemic. The program focused on individuals who had been hospitalized for acute respiratory conditions. Every member received transition of care calls following discharge regardless of the complexity of the case.

Individuals who were discharged on oxygen got additional calls for five days. During these calls, key indicators were reviewed like oxygen saturation levels, shortness of breath, temperature, nausea, and other symptoms of infection.

Case Managers facilitated clinical conferences with primary care and/or urgent care providers to immediately address any areas of concern upon detection, and these timely interventions kept members out of the hospital. Kaiser Permanente reduced their readmission rates by 1 percent, and patient satisfaction was increased. 

Additionally, the Kaiser model helped retain case management staff at a crucial time. During the pandemic, staff turnover had reached a 40% vacancy level. Case managers were still trying to see patients in person, and caseload disparities occurred because of staffing shortages. This disparity contributed to consistent staff leaving or expressing that they were seeking employment elsewhere. The team established a program that pooled staff resources to balance caseloads across all organization partner sites resulting in recruitment of new staff and stabilization of existing staff. 

The CMSA Foundation chose to recognize the Kaiser Permanente program with a Practice Improvement Award because this model is translatable and can be adapted to multiple practice settings. The Foundation’s goal is to recognize and share evidence-based practices that can be replicated. By conducting ongoing outreach post-discharge, promoting treatment plan adherence, and responding quickly to any negative symptoms, the program kept individuals out of the hospital.  As we enter flu season and with the Respiratory Syncytial Virus (RSV) presenting a dangerous risk for many, it is a good time to highlight the Kaiser Permanente model that demonstrated strong results.

It is also a good opportunity to highlight the work of the CMSA Foundation. Since 2019, the CMSA Foundation has provided scholarships, grants, and awards totaling over $34,000. The vision of the Foundation is to become the leading philanthropic organization that enhances the practice of case management resulting in better health outcomes.    This vision can be achieved through research and sharing best practices. The Foundation also supports Public Policy initiatives that advocate for greater access to case management services. The CMSA Foundation is a non-profit organization led by volunteers, and all its bequests are funded entirely through donations. Without the CMSA Foundation, there would be few platforms to promote the accomplishments of Case Managers. It is vitally important to raise awareness about the ingenuity and impact of Case Managers. Please consider supporting the Foundation’s work through a tax-deductible contribution. It is a good investment in your profession.

The CMSA Foundation is a charitable, non-profit organization that advances the practice of case management through grants and awards focusing on case management research, practice improvement, and public policy. Learn how you can support the mission of the CMSA Foundation by clicking here: https://www.cmsafoundation.org/about

Bio: Alan Boardman is a Licensed Social Worker with over 27 years of experience.  His career has focused on serving individuals living with chronic Behavioral Health conditions, Serious Mental Illness, and complex, co-occurring conditions.  Alan is currently serving as the President of the CMSA Foundation Board.  He has previously served as a Foundation Director, and he was a member of the CMSA Foundation Advisory Committee, the CMSA Finance Committee, participated on the Standards of Care Committee, and has completed CMSA’s Integrated Case Management program. Alan is currently the Director of Clinical Program and Quality Management in Behavioral Health at a large New York City based health plan.  He is responsible for the development and management of its comprehensive Behavioral Health Quality Management Plan and all related strategies.  Additionally, he implements and oversees innovative, value-based clinical programs that employ integrated case management models to improve treatment outcomes.