Hospital Case Management: A Review: 2019-2022.

PURPOSE/OBJECTIVES: In June 2019, a Case Management Society of America (CMSA) task force published "The Practice of Hospital Case Management: A White Paper." This was an important first step to outline the value of hospital case managers (HCMs) and to put forward recommendations for how to operationalize a major change in most hospitals for how case managers can practice.The SARS-CoV2 (COVID-19) pandemic drastically changed the practice of all interdisciplinary work within hospitals. The White Paper recommended that HCMs follow a select patient population through the hospital. Hospital case manager leaders realized that HCMs can work remotely and communicate with patients because meeting them in person was not an option. Hospital case managers are still resistant to leaving the hospital unit-based model, even after they experienced the value of this concept during the height of the pandemic. PRIMARY PRACTICE SETTING: Acute care hospitals. FINDINGS/CONCLUSIONS: The White Paper recommended separating HCMs from utilization management. One unintended consequence is the loss of necessary knowledge and competencies. These are related to compliance with the Centers for Medicare & Medicaid Services Conditions of Participation and regulatory mandates that can affect patient care and financial well-being. Hospital case manager leaders must stay current with these government requirements for hospitals and for all levels of care and keep the case managers informed, proficient, and fluent when coordinating the care of patients. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Hospital case manager practice is evolving; change is the single constant in health care. This review of the CMSA Hospital Case Management Whitepaper demonstrates that in just three short years, the landscape of health care can change dramatically.Today's HCM leader must proactively address a multigenerational workforce, lack of title protection, and the COVID-19-induced "Great Resignation." The value of the HCM has never been more apparent as during the pandemic as the need to "empty beds" is critical, and the HCM is the professional who has the skill to provide efficient and patient-centered care coordination. The HCM leader practices positive leadership techniques that benefit the leader, the HCM, and most importantly the patient.

Heat- and Light-Responsive Materials Through Pairing Dynamic Thiol-Michael and Coumarin Chemistry.

Covalent adaptable networks (CANs) based on the thiol-Michael (TM) linkages can be thermal and pH responsive. Here, a new vinyl-sulfone-based thiol-Michael crosslinker is synthesized and incorporated into acrylate-based CANs to achieve stable materials with dynamic properties. Because of the reversible TM linkages, excellent temperature-responsive re-healing and malleability properties are achieved. In addition, for the first time, a photoresponsive coumarin moiety is incorporated with TM-based CANs to introduce light-mediated reconfigureability and postpolymerization crosslinking. Overall, these materials can be on demand dynamic in response to heat and light but can retain mechanical stability at ambient condition.

Anilinium Salts in Polymer Networks for Materials with Mechanical Stability and Mild Thermally Induced Dynamic Properties.

Dynamic nucleophilic exchange of quaternary anilinium salts has been incorporated into rehealable and malleable polymeric materials that can be activated under mild (60 °C) thermal stimulus. The mechanism of dynamic exchange between quaternary anilinium salt and free aniline was assessed in small-molecule model experiments. The dynamic exchange was found to be dissociative in nature, due to the indirect SN2 mechanism, where initially the bromide anion attacks the anilinium salt to generate an alkyl bromide which undergoes subsequent attack by a free aniline group. A quaternary anilinium-based cross-linker was synthesized to act as dynamic linkages in the polymer network. Cross-linked polymeric materials showed thermoresponsive rehealing and malleability properties at 60 °C along with being resistant to irreversible creep under ambient conditions. The use of anilinium salts enables dynamic exchange to occur with significantly milder thermal stimulus than other comparable materials, while maintaining mechanical stability.