Meet Healthcare Case Management Manager Teresa Treiger: Helping Clients Bridge Gaps To Self-Advocacy, Self-Management

Friday, September 14th, 2012
This post was written by Cheryl Miller

This month we provide an inside look at a healthcare case management manager, the choices she made on the road to success, and the challenges ahead.

Teresa M. Treiger, RN-BC, MA, CHCQM-CM, CCM, Founder of Ascent Care Management, LLC

HIN: Tell us a little about yourself and your credentials.

Teresa Treiger: My given name is Teresa, but most people know me as Teri. I am a registered nurse although my educational background also includes degrees in healthcare administration and business. I have over 30 years of cumulative experience in the healthcare industry with more than 20 of those devoted to care coordination and care management. I am certified in case management by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP,) the Commission for Case Manager Certification (CCMC,) and the American Nurses Association (ANA.) I am also certified as a chronic care professional by the Health Sciences Institute (HSI.)

What was your first job out of college and how did you get into case management?

As so many of us did, I started off with bedside nursing on a general medical-surgical floor before moving to neurosurgery, orthopedics, respiratory intensive care, and urgent/emergent care. When it was time for a change of pace, I shifted to the business side of healthcare for a couple reasons:

  • I did not believe that the business of healthcare was enough of a concern for the people who worked within the sector. It was far too easy to not consider the financial implications of care when all I had to do was take a sticker off of a piece of equipment and place it on a patient’s supply charge sheet. I’ll expand on that more in a bit, and
  • I did not feel as though I was making an impact on the bigger picture of healthcare; bedside nursing was and is a wonderful experience but I knew I needed to make a different kind of impact. Subsequently, I worked in case management in a variety of settings – managed care, acute hospital, rehabilitation and long term care settings eventually focusing on care coordination program design/implementation and education.

Has there been a defining moment in your career? Perhaps when you knew you were on the right road?

This is an interesting question because my defining moment was not necessarily what got me into case management but rather what validated the choice I made as being perfect.

I was at a crossroads, having just undergone a corporate restructuring which left me unemployed. I attended a Case Management Society of New England (CMSNE) chapter conference on leadership and it literally changed the trajectory of my career path, but not because it was case management-focused. It validated that the business of healthcare delivery was in dire need of a focus point. With all due respect to clinician providers, their job is not to coordinate how the care is delivered – and they aren’t all that good at it. By and large, they are great at diagnosing and providing the blueprint of an individual’s care, but how that all gets accomplished — not so much.

In brief, describe your organization.

I am a case management consultant and have my own company, Ascent Care Management, LLC. I work with individuals who desire their own case manager, but the bulk of my business is focused on business clients who want to revamp their case management departments in one way or another. Frequently, I help organizations through process flow redesign, documentation, case management IT projects, and accreditation preparation. I also enjoy public speaking on a variety of healthcare and care management topics.

What are two or three important concepts or rules that you follow in case management?

  • Don’t ever lose sight of the fact that behind every number is a patient.
  • Treat others with the courtesy and respect with which you hope to be treated.
  • How you are perceived as a case manager will be a reflection on every other person who refers to themselves as a case manager, so I make it a good experience for the client.

What is the single most successful thing that your organization is doing now?

I have a case management boot camp that has been well received. Often what I have found is that individuals transition into case management because of the work hours or other reason rather than actually wanting to make case management a professional adventure. Training is so vastly different from one organization to another that there is really very little actual training aside from the information system and day to day work flow process. The boot camp focuses on the actual steps of the case management process through interaction and exercises to help individuals to have a better framework for working with clients toward measurable and achievable goals. The way I see it, the case manager should be considered to be a bridge to self-advocacy and self-management of their own healthcare rather than a crutch.

Do you see a trend or path that you have to lock onto for 2012? 2013?

I see a few things…

  • Many PPACA provisions kick in during 2012 to 13. Knowing what is coming up for implementation will help case managers ramp up for what they need to understand.
  • Many health systems are implementing their own brand of case management and unfortunately it simply requires a change in an individual’s job title rather than an evaluation of skill sets and provision of training and development opportunities in order for that person to be successful. These types of programs are going to be running aground and a need for knowledgeable case management consultants will bloom as the C-suite opts to address these less-than-successful programs.
  • The home care sector needs for case management are going to blossom as transition of care programs begin to engage more services to avoid readmissions.

What is the most satisfying thing about being a case manager?

Having an impact.

Some days it might be a very small thing, but to the individual I have worked with, whether mentoring a newer case manager or working with a client, it is something of great importance. I like that what I do is a positive contribution rather than a negative detraction. It is too easy to whine about this or that. Then I look around at the challenges others are facing and realize how fortunate I am to be able to help improve the lives of others. That is a gift.

What is the greatest challenge of case management and how are you working to overcome this challenge?

The biggest challenge is that of complacency. I wrote about this in a recent blog post and summed up with the following… “Health care is always changing… consumer expectations are on the rise… and case managers are being viewed by many as a critical factor of successful patient-centered care coordination. I believe that an overwhelming number of case managers are up to the challenge being placed before them. The essential element that we must remain mindful of is to never fall into the pit of thinking that we know it all or that do not need to consistently and continuously improve the quality of the service we bring to the health care team.”

What is the single most effective workflow, process, tool or form case managers are using today?

This is a great question for which I do not know an answer exists. Because case managers work in so many different settings of care, a tool or process that is great in one setting may not work in the next. However, with that said, I think that technology has the greatest potential for being the most effective tool… but it depends on the case manager and his/her ability to use it effectively and efficiently.

Where did you grow up?

I was born in Boston, Massachusetts and lived there for the first few years before moving to Hawaii for three years. We returned to live just south of Boston for the rest of my childhood and adolescence.

What college did you attend? Is there a moment from that time that stands out?

I have an ongoing love of learning so my education has progressed through a number of institutions: Laboure College, Stonehill College, Boston University, University of Phoenix. Currently, I am considering a return to school to earn my Doctor of Nursing Practice degree.

Are you married? Do you have children?

Yes, I am married to Dave Treiger. We will celebrate our 10th anniversary in August 2013. I have two furry children, cats whose names are Tang and Skooch.

What is your favorite hobby and how did it develop in your life?

I enjoy photography. It was something I used to do with my Dad that started when I was in high school. I still have both of our old SLR cameras… but now I primarily use a digital Nikon SLR.

Is there a book you recently read or movie you saw that you would recommend?

It’s a classic but it remains my favorite book of all times, A Tale of Two Cities by Charles Dickens. I can’t tell you how many times I have read it since high school. As for a movie, I hate to sound so down on them but the quality of movies that have been made in the past 5 to 10 years has been less than overwhelming. Nothing really stands out that I would risk recommending to a friend.

Any additional comments?

Case management has changed my life and afforded me opportunities to travel around the world to share my experiences and learn about how case management is done in other healthcare systems.

I think that the case managers of today (and tomorrow) have to find ways in which to be proud and passionate about what they do and the critical part that they play in the healthcare delivery system. Our opportunities are endless so if a job isn’t working out to your expectations, find another one. Don’t allow complacency and resignation to direct your career choices. Envision your goals and then make them happen.

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