A paramedic who survived a helicopter crash to become an RN. An airport ground worker who overcame a serious puncture wound to return to lead his crew. A proud veteran who regained use of his left arm after a devastating shoulder injury.
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Across the nation, case managers at Genex Services make life-changing impacts on injured employees on a daily basis. And the professionals involved in these three cases have earned special merit by winning one of the most prestigious industry honors: the 2019 Heart of Case Management Award.
Now in its fourth year, the Heart of Case Management Awards is a national program recognizing Genex case managers who are highly regarded for transcending beyond their traditional job duties to improve the lives of thousands of injured employees each year. The three winners were nominated from a field of more than 1,600 Genex case managers across the country and judged on the following criteria: specialist, excellence, adaptability, trust, influential communication and outcomes.
Watch the video to see how the winners changed lives for the better.
The following are synopses of the winning entries.
Field Case Management
Julie Wilcox, RN, MSN, BSN, CRNA,
Baraboo, WI
Case managers make the greatest impact when they’re
assigned to a case soon after the injury occurs. When this doesn’t
happen, it can significantly delay recovery and often prevent the
injured employee from getting back to work. This was the challenge Julie
Wilcox faced when assigned to a case involving an employee mired in
eight months of pain and inactivity due to a significant left shoulder
injury which rendered him unable to work or perform activities of daily
living. Upon one of her first visits, the man admitted to Wilcox he felt
“the world had given up on him” and was extremely depressed and
suicidal. With no appropriate treatment path to follow, the injured
employee had been prescribed multiple narcotics, anti-inflammatories and
muscle relaxants for pain relief to no avail. Wilcox initiated a more
aggressive treatment strategy, collaborating with orthopedic and pain
management specialists. She secured approval to proceed with an
extensive shoulder procedure. Wilcox worked closely with the surgeon,
physical therapists, employer and employee to formulate an appropriate
transitional rehabilitation plan. She also prioritized narcotic weaning
by implementing the Genex Opioid Usage Case Management Care Path and
collaborated with the employer to develop regular job and appropriate
light-duty accommodations. To facilitate compliance, Wilcox regularly
visited and encouraged the injured employee, discussing strategies and
goals to assist him through range of motion, strengthening and work
conditioning. Her work paid off as the man regained full functional use
of his previous non-functional left arm, leading to a full-duty return
to work.
Telephonic Case Management
Sara Fleming RN, CCM,
Mansfield, TX
A 58-year-old ramp crew chief from a major
airline company sustained a significant puncture wound after striking
his lower leg on a tow bar used to move aircrafts. The injury soon
manifested into a serious bacterial skin infection which did not respond
to two rounds of oral antibiotics. Sara Fleming was called on the case
to expedite treatment and develop a return-to-work plan. She quickly
utilized Official Disability Guidelines (ODG) to develop a wound care
protocol, preventing a utilization review which would have significantly
delayed treatments and could have resulted in a negative outcome for the
injured employee. Facing a lack of available in-network wound
specialists to treat the injury, Fleming enlisted the assistance of a
partner vendor to help identify a provider, further expediting
treatment. Fleming also strongly advocated and supported the worker by
emphasizing the importance of care plan compliance, ensuring he attended
his appointments and follow-up visits. Despite limited available
transitional work opportunities, Fleming collaborated with the employer
to obtain a transitional duty release 32 days prior to ODG estimates.
Her efforts soon resulted in a full return to work for the injured
employee.
Catastrophic Case Management
Charlene Ramsey RN, BSN,
CCM, Phoenix, AZ
When a catastrophic event plays out on the
evening news, most don’t realize that Genex case managers are often
behind the scenes triaging care and directing services to injured
workers. Such was the case when a 37-year-old flight paramedic survived
a helicopter crash in a rugged mountain terrain. Despite sustaining
multiple injuries including fractures to his legs, shoulder blade and
ribs as well as severe chemical burns, the paramedic quickly attempted
to save a dying coworker before attracting the attention of aerial
rescue teams by using his cellphone flashlight. He was airlifted to a
local trauma center, where he underwent extensive leg surgeries.
Charlene Ramsey was assigned to the case and immediately met with
medical staff, family and the claimant to coordinate a timely pre- and
post-op treatment plan for multiple surgeries throughout his case.
Tragically, the man was the sole survivor of the crash. Noting his
history of PTSD from prior military experience, Ramsey ensured
additional psychological protocols were included in the care plan. As
the injured worker progressed, Ramsey orchestrated a seamless transfer
to an inpatient rehabilitation facility where he continued to recover
until he was deemed safe for discharge. She then coordinated and
attended all outpatient appointments with multiple specialty providers
and developed a successful graded return-to-work plan. With Ramsey’s
support and guidance, the claimant also continued his education to
become a registered nurse, which he successfully completed five months
before predicted maximum medical improvement. Despite multiple serious
injuries and treatment, the claimant returned to work far ahead of ODG
estimates. Today, he works as an RN at the trauma center where he was
treated. For their remarkable accomplishments, Ramsey and the claimant
were recognized by the Arizona Workers’ Compensation Claims Association
with the Rehabilitant of the Year Award.
More in-depth information on each case management story can be found at www.genexservices.com/fromtheheart
About Genex Services, LLC
Genex Services (www.genexservices.com) provides best-in-class clinical solutions that enable customers to transform their bottom lines while enhancing the lives of injured and disabled workers. Genex, a clinical management leader throughout North America, serves the top underwriters of workers’ compensation, automobile, disability insurance, third-party administrators and a significant number of Fortune 500 employers. In addition, Genex clinical services are enhanced by intelligent systems and 360-degree data analysis. Its clinical expertise consistently drives superior results related to medical, wage loss, and productivity costs associated with claims in the workers’ compensation, disability, automobile, and health care systems. Genex Services and Mitchell International merged recently to create the broadest continuum of technology and products servicing the auto, workers’ compensation, and disability markets.
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Contacts:
Genex Services
610-964-5213
tom.kerr@genexservices.com