URAC defines Case Management as “a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet a consumer’s health needs through communication and available resources to promote high quality, cost-effective outcomes.” This process is especially critical in the area of neonatology.

Neonatal Case Management is challenging. Case managers need to have the clinical and technical expertise to understand the medical as well as social issues which need to be addressed. Consider the following to effectively case manage neonates while they are in the NICU:

• Utilize a structured process that guides the case manager in understanding the neonate’s clinical status and challenges.
  
  
• Identify early what is needed. Proactively case manage the infant’s stay.
  
  
• Identify appropriate community resources.
  
  
• Educate and provide the parents with helpful information that will increase their comfort level in caring for their baby and ensure a safe and stable home once the infant is discharged.
  
  
• Educate and help the parents to become proactive advocates for their infant. Coach them on what questions to ask; give them things to do in the discharge planning process. Many NICU’s have problems with delay at discharge. 30 percent of neonate discharges are delayed for non-medical reasons.
  
  
• Develop parents’ role in discharge planning process.
  
  
• Create appropriate timing of discharges and preparation of both baby and parents for discharge decreases readmission rates.
  
  
• Support & educate parents and facilitate early interactions with their infants might be the most cost-effective intervention available.This process increases parent satisfaction and decreases costs by decreasing length of stay.

Continuing to case manage the infant after discharge is also critically important. Spending time communicating with the family early and frequently and thoroughly communicating with patients, providers, family members and the health plan has been shown to reduce the need for unnecessary emergency care and hospitalization after the initial discharge.

The complex nature of many NICU patients requires a smooth connection with community resources to facilitate transition to the next level of care. A safe transition of high-risk infants from hospital to home requires:

• A thorough understanding of discharge criteria.
  
  
• Coordination and progression of educational activities that prepare families for caring for their infant at home.
  
  
• Appropriate identification and utilization of referral services.
  
  
• Preparing the parents to accept their role as independent caregiver.

For more information about services and resources available to help neonatal case managers, please call Rhonda Parry at 770-856-7150 or email rparry@neonatalconsult.com.