Hire Care Coordinators Strategically

The need for care coordinators is growing, but because they must be able to work with specific patient populations, careful and strategic recruiting practices are vital.

In an effort to drive down readmissions, many hospitals, clinics and healthcare systems have established the role of care coordinator to guide patients through the system and keep care programs on track.

But what a care coordinator is and what a care coordination team should look like may mean different things at different organizations.

Some are asking care coordinators to be interdisciplinary chimeras with the clinical knowledge of a registered nurse, the people skills of a social worker, the organization and planning ability of a personal assistant and a heart of gold to boot.

Unless you are very lucky, you probably won't find an entire team of people who all have those skills. So rather than focusing on a handful of exceptionally talented people, it makes more sense to hire a diverse team from varying backgrounds.

"A care coordination team is multidisciplinary. It's not just one person or one role," says Nancy Skinner, president of the Case Management Society of America and Riverside Healthcare Consulting. "Nurses and social workers have a professional background that brings the [clinical] knowledge that is necessary to begin a path to be a care coordinator… We have typically put people in this role because of the initials after their name. We can't do that anymore—we have to look at the capabilities of the person moving into that role," she says.

Attention to Detail
In Skinner's opinion, the most important traits of a case manager or care coordinator are excellent communication skills, specifically with the patients they serve; extensive knowledge of the U.S. healthcare system; and the ability to navigate it for their patients. Finally, but perhaps most important, are sharp assessment skills and perception.

The ability to understand what the patient understands—and doesn't understand—and to look at their circumstances, including where they live, what kinds of assistance they have access to and [to be able to] accurately assess their situation—is a rare skill, but indispensable for a care coordinator, says Skinner.

"Does the coordinator truly understand what care coordination is? It's a process," she says. "Discharge is an event. We have to understand the process that leads to that patient being handed over to the next level of care, whatever that may be."

Ann Lindsay, MD, co-director at Stanford Coordinated Care, which serves the high-risk population among both Stanford University and Stanford Hospital's employees and their families, agrees that being thorough and detail-oriented and showing a strong interest in patients are vital skills for a care coordinator.

"When we interview people, we propose clinical situations to see how they would approach [them]. This gives us an idea of their creativity and their interest in people, and shows they see that people are people, not just numbers," Lindsay said.

Into the Patient's Hands
Ultimately, the perfect care coordination team is a team crafted for a specific patient population.

Lindsay recalls the process Stanford Hospital's administration went through when it first began putting together its coordinated care program.

"We interviewed the first intended recipients of coordinated care. We looked at the data we had on those patients, and learned that our audience had many medical issues," she says. Quite a few of the patients saw multiple specialists and took multiple medications, and they also had high incidence of depression and chronic pain.

Lindsay recalls feeling that the patients didn't just need care coordinators—they needed advocates—which Stanford's coordinated care team brought on. They also hired clinical social workers, pharmacists, physical therapists who specialized in pain management, and a dietician to try to help combat the high incidence of diabetes and obesity.

For the population Stanford's team serves, that was the perfect combination of skill sets, and has led to a successful and popular program.

Each patient group is different, and will require different skill sets, but what's most important, both Skinner and Lindsay agree, is that care coordinators can reach the patient and motivate them to be a part of their own care.

Reduce Readmissions by Activating Patients to Do 'Self-Care'

"You have to make the patient part of it," said Skinner, suggesting that care coordinators be passionate about educating their patients, giving them goals, following up with them and empowering them to take their health into their own hands.

"An emphasis on self -management is important," says Lindsay. "If you give a man a fish, he'll eat for a day. If you teach a man to fish, well, he'll know how to fish."