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Brain injury case management

Meet the case manager: Rachael Hazlett, Keystone Case Management



In this edition, we hear from Rachael Hazlett about her journey from physiotherapy to case management

Rachael, you are a physiotherapist by training but are a case manager for Keystone Case Management. Why the switch?

Prior to becoming a case manager, I found that there were limited options within my physiotherapy role to progress my career whilst retaining the same level of client contact that I wanted.

For many physiotherapists, progression comes with relinquishing the application of their clinical skills in favour of more managerial roles.

I wanted to retain contact with clients.

Additionally, I found I was drawn to working more holistically with a person rather than focusing on one main aspect of their health, usually the injury they had come to me with, and was always wondering what had become of them following my relatively short intervention.

Physiotherapy is only one part of their rehabilitation.

Being a case manager allows me to use my qualifications and professional background to develop a longer-term relationship with a client and to obtain a bigger picture of how what has happened to them affects their whole life.

It means I can be involved in different areas of their life, not just their physical health, and accompany them through the whole recovery process, not just for a phase of treatment.

For me personally, I was also looking for a role which provides much needed flexibility in my current life stage. Case management offers this.

Why Keystone Case Management?

I particularly liked the client demographic that Keystone works with.

That is, clients who have had catastrophic injuries which hugely impact on all areas of their lives.

While devastating for the individual, they provide problem-solving challenges for me as a professional.

I also considered the level of experience of Keystone’s senior management team and peer support of their experienced case management team advantageous to me.

Given that they were influencing change within the sector and had considerable expertise between them, I deduced that I was working with some of the best in the industry.

What aspect of case management do you personally enjoy the most?

The working relationship with the client and their families.

I very much prefer having a smaller caseload of clients that I can really get to know and with whom I can build a significant, long-standing therapeutic relationship. 

I also really enjoy liaising with other professionals and people in the client’s life who are all, together, trying to facilitate a difference.  

Which of your clinical skills have been most helpful in your case management role?

It is probably my skills in multidisciplinary working.

Being able to liaise with other professionals, identify who the client needs to assist them at any point in their rehabilitation and coordinating the team.

I often feel like I’m the ‘translator’ in helping the professional to understand the needs of the client, and then educating the client as to what the healthcare professional is doing and saying.

It is important to use the right language for the client to fully understand what is happening to their body and where they are in their rehab process.  

Also, subjective assessment is a skill which is very much needed in a case management role.

My post-graduate work was focused on clinical reasoning and on asking the ‘right’ questions.

Excellent clinical reasoning is needed to obtain a good subjective assessment of the client.

What has been a particularly satisfying goal achievement with one of your clients?

More recently, one of my clients with young children had been unable to return to the family home on discharge as her newly acquired disabilities made it unsuitable.

However, working with other professionals, we were able to get her back into her own home after five months of being away from her children, which was very rewarding to oversee.

Is there any advice you would give to any other physiotherapy colleagues wanting to become a case manager?

Firstly, I would encourage my physiotherapy colleagues to seriously consider case management as a rewarding and fulfilling career option. 

I would also say, do not be put off by the litigation aspect which is an interesting adjunct to the work.

Many of my colleagues are not keen on ‘paperwork’ but the report writing and notes writing needed are not dissimilar to what is required in many jobs.

Unusually for other sectors, these are considered of equal value in terms of expertise.

How important is the role of the IRCM do you think?

I can see that IRCM are trying to protect the client which is essential.

Any profession with a governing body is more highly regarded and so the IRCM has an important function.

When you’re not case managing what other activities occupy your time?

Lots of dog walking, bike riding, and chasing a four-year-old around!

Occasional yoga sessions or running has become a luxury over parental responsibilities.

Keystone is currently recruiting for case managers and expert witnesses – click for more details