Patti Tipton, BSN, RN, LNC, CCM, National Care Management, Richfield Dedicated Unit
Tell us a little about yourself and your credentials.
I am a registered nurse (RN), and achieved my BSN in 1988. I have over 24 years of experience in the nursing industry, which includes intensive care unit (ICU), trauma level emergency room (ER), labor and delivery, long term nursing, home healthcare, management, and case management. I am certified in case management by the Commission for Case Manager Certification, and also completed the legal nurse consultant certification program in 2000.
What was your first job out of college and how did you get into case management?
With great pride, upon graduation from nursing school, I entered into active duty as an RN in the United States Air Force (USAF). I served active duty during Desert Storm, from 1988 to 1991. Thereafter, I remained in Indefinite Ready Reserve, until I was honorably discharged from the USAF in 2005.
Like most nurses, I acquired a variety of nursing experiences before transitioning into case management. My initial case management experience began as a perinatal case manager in the home health industry in 1996, when I transitioned from the labor and delivery unit of a university-based hospital system to their home health division; I was an integral part of the creation of their first perinatal home health program, PerinatalConnection. Due to the need for more flexible hours to care for my family and an elderly parent, I returned to the trauma ER for a nursing agency, until I began working for Aetna as a RN case manager in October 2006.
Has there been a defining moment in your career? Perhaps when you knew you were on the right road?
I have had many defining moments in my career, all of which support my reasons for going into the healthcare field: the desire to help others. One of my first defining moments was while in nursing school, picking glass from a 20-something year old man’s head and face, while he lay in his ICU bed after his auto accident. He looked at me and said, “You are a Christian, aren’t you? I can tell that you care just by the way you treat me.” I thought to myself, “Wow…actions do speak louder than words,” and I knew I had chosen the field that was for me.
In brief, describe your organization.
Aetna is one of the nation’s leaders in healthcare, dental, pharmacy, group life, disability insurance, and employee benefits. Dedicated to helping people achieve health and financial security, Aetna puts information and helpful resources to work for its members to help them make better informed decisions about their healthcare. I am very proud to work for Aetna, and on a daily basis, embrace and connect with patients in their situations, and empower them with the knowledge to make educated decisions regarding their healthcare needs.
What are two or three important concepts or rules that you follow in case management?
First, I truly believe in treating people as you would like to be treated, embracing people as though they were your own family.
Secondly, I firmly believe that people can make better healthcare decisions when they have the appropriate knowledge. As a case manager, I ensure patients understand their medical benefits, as well as their medications and physician’s treatment plan.
Do you see a trend or path that you have to lock onto for 2013?
It is no surprise that healthcare needs to be more affordable for everyone. We need to advocate solutions that will support and motivate patients to be in charge of their own health. I know that for myself, I really think about what an ER visit will cost, versus waiting to see my primary care physician (PCP). This helps me to decide "is it really all that urgent?” As a case manager, I know that reduction of ER visits and avoidable hospital readmissions are one small part of decreasing healthcare costs. Having worked in ER departments, I have seen patients use the ER as their PCP, despite encouragement to select a PCP or follow up with their PCP. Patients many times use the ER because it is more convenient or accessible for them. Motivating patients to be more proactive with their health means promoting more cost effective ways that enable accessible and appropriate healthcare services.
What is the most satisfying thing about being a case manager?
It is all about the opportunity to connect with a patient and make a difference in their life. Sometimes, it is educating a patient about a medical benefit they did not know they had. Other times it is outreaching to the physician to make sure he/she understands their patient’s current situation, or assisting with the transfer of a member from a facility in one state to a facility in another state.
What is the greatest challenge of case management and how are you working to overcome this challenge?
Promoting self change in our members. It is obvious that someone who is obese should lose weight, someone who smokes should quit. Use of motivational interviewing techniques improves communication with patients to promote self change, where the patient identifies the agenda and goals.
What is the single most effective workflow, process, tool or form case managers are using today?
Motivational Interviewing (MI). Using MI techniques makes Aetna’s care management program different by encouraging engagement of the member when exploring the root cause of their health issues or concerns. MI is successful in guiding members to transition from unwillingness to discussing their issues to seriously considering self change. MI helps case managers improve health behaviors and outcomes, increase member engagement in Aetna programs, and improve member satisfaction.
Where did you grow up?
That is a loaded question! My father was a Methodist minister, so I moved a great deal; however, the majority of my childhood was in various towns in Tennessee. Cumulatively over my lifespan, I have lived in eight different states: Ga., Fla., Tenn., Colo., N.C., Ark., Ill., Ohio.
What college did you attend? Is there a moment from that time that stands out?
I received my Liberal Arts degree from Martin Methodist College in Pulaski, TN, then received my BSN from Tennessee Technological University in Cookeville, TN. In 2000, I completed the first Legal Nurse Consultant certificate program that was offered by Cuyahoga County Community College in Parma, OH.
I must admit nursing school was a tough and competitive program, sometimes feeling like it was a weeding out process of the strong versus the weak. Therefore, it was a huge accomplishment to complete nursing school as well as pass my state nursing boards. When I returned to college in 1999 for the Legal Nurse Consultant program, I found it to be a different level of learning for me. I did not feel it was a forced to learn situation; rather, I had the strong desire to learn something new and incorporate my nursing experience into the legal arena.
Are you married? Do you have children?
I have been married to my best friend, Michael Tipton, since 2003. We share a blended family of boys, ages 17 to 26.
What is your favorite hobby and how did it develop in your life?
Sewing, which I learned from my mother. At a very young age, I was making my own Barbie doll clothes, then my own clothes once I became a teenager. I enjoy the creativity and usually can’t wait to see the final product!!
Is there a book you recently read or movie you saw that you would recommend?
The movie, “The Pursuit of Happyness.” I love Will Smith as an actor, and appreciated the challenges his character faced and overcame. It showed what desire, perseverance and integrity can achieve.
Any additional comments?
As I mentioned before, I am very proud to work for Aetna, and be part of their focus toward solutions for improved, affordable, and accessible healthcare systems. It is also rewarding for me to help our members realize that we, as case managers, are genuinely here to help them. It makes my day when I hear “Wow, you really do care….I guess the bad name that insurance companies have out there is not always true.” Every day, I strive to provide the core values of Aetna: integrity, caring, excellence, and inspiration.
