Navigating the roadmap to independence for patients is the concerted effort of an interdisciplinary team approach to rehabilitation. Leading the way is the case manager and social worker duo.
CARF, the Commission on Accreditation of Rehabilitation Facilities, requires that a designated person oversee each patient’s care. At Madonna, this pivotal role is assigned to a case manager. They collaborate with the team and physician to achieve a patient’s medical and personal goals. “I prepare team care plans including evaluations for new admissions and weekly progress reports on existing patients,” said Andrea Donscheski, case manager at Madonna’s Lincoln Campus Specialty Hospital.
Case managers are master liaisons who ease the burden for patients. “I coordinate and communicate with their insurance company, and relay financial information to the patient and family,” said Donscheski, who is also a registered nurse. She provides medical and therapy updates for continued coverage and obtains authorization for medical procedures.
“A major challenge is accomplishing as much as we can for a patient within a limited time frame,” explained Donscheski. She relies on a social worker, nursing and clinical teams to achieve the highest outcomes. Additionally, she monitors insurance benefits and Medicare days, deciphers complicated disability, FMLA and Medicare paperwork for patients and finalizes discharge plans. “I connect weekly with patients to discuss progress and address concerns.”
Donscheski earned undergraduate and graduate degrees in nursing, and is a Certified Rehabilitation Registered Nurse, with expertise in caring for people with physical disabilities and chronic illnesses. “I enjoy working with a talented group of professionals and building relationships with patients and their families.”
Madonna case managers partner with a social worker and the two work closely as patient advocates. Sandra Slama, a certified social worker with a bachelor’s degree, shares an office with Andrea. Her specialized training helps people understand the emotional, physical and financial impact of an illness or injury.
Slama implements a patient’s safe discharge plan and maintains communication between the interdisciplinary team, patients and families. Her extensive experience includes 24 years at Madonna. She offers counseling on decisions and locates services or equipment for patients and any necessary funding. Slama is proud to be part of a team impacting lives. She hears the appreciation in a patient’s voice during a post-recovery phone call and sees it first-hand in their thank-you cards or personal visits.
“It’s gratifying to witness a patient’s progress as they move through the continuum of care,” Slama said. “To see their pride of accomplishment and knowing I had a small part in their journey is the ultimate reward.”