Case Management

Social Work Service

Discharge planning begins the day a patient is admitted to the hospital. It sometimes takes several days to plan and ensure our patients have everything needed for a smooth transition to home or other facility. The social workers assist our patients with:

• Needed medical equipment such as walkers or wheelchairs
• Transfer to a care or rehabilitation facility
• Transportation
• Psychosocial or psychological issues related to their illness
• Crisis intervention
• Emotional support and links to area agencies and services for Hospice patients and their families

Nurse Case Managers

Nurse case managers are an important link among patient and families, insurance companies, and physicians. They are a good resource for patients and families with insurance coverage concerns, and for physicians focusing on quality care for their patients.

• Nurse case managers and social workers communicate with health team members within the hospital to develop plans for patient’s care in the hospital and at home.
• Patient and families are included in the healthcare team decisions.
• Communication with insurance companies, during the hospital stay, is necessary to assure appropriate coverage for the patient.
• Nurse case managers in the Medical Surgical unit, Telemetry and the Intensive Care unit review all inpatient admissions daily.
• Dialogue occurs between physician and case manager each day to determine patient medical needs.

Living Will and Advanced Directives

All states have laws to help you make future health care treatment decisions now, so if you should become incapacitated and unable to make these decisions in the future, your family, and doctors will know what medical care you prefer or do not want. In Arizona you can appoint a person to make your health care treatment decisions if you become incapacitated. These laws are called “advance directives” or “health care directives.” The Advance Directive program utilized by Canyon Vista Medical Center follows Arizona law.

Most people communicate their health care directives by completing the Advance Directive forms tailored to make prompt decisions about treatment choices. Before you complete these or other health care forms, you should learn and think about what medical treatments you want or do not want in the future. Discuss your choices with your family, loved ones, physician, or spiritual advisor. Also, consider whom you want to appoint to make treatment decisions for you if you cannot speak for yourself. Although you cannot anticipate all the medical situations that may arise, you can give guidance to your decision-maker, doctor, and family as to your values and choices, so they can respect your wishes if a time comes when you cannot make or express decisions for yourself.

It is not necessary to have Advance Directives prior to surgery or hospitalization. However, if you are admitted and decide that you would like to formulate your Advance Directives, our social workers can help you complete the necessary forms or we can supply you with the information upon your discharge.