One of the best kept secrets in Arkansas, Cheri Lattimer says, is that the national headquarters of the Case Management Society of America is found right here in Little Rock. Lattimer, RN, BSN, has been executive director of CMSA since moving to Arkansas in 2005. The role is more than a job for her; it's the culmination of a lifelong passion for making life better and easier for patients and their families.

 

Born and raised in Southern California, Lattimer said she was drawn to helping patients from a very young age—so much so that her very first "patients" had been injured by her own design. "My mother would tell you all of my 'babies' had horrible accidents and were in terrible condition when I was a little girl, so I had to take care of them," she laughed.

 

Lattimer, of course, outgrew her dolls, but never her interest in taking care of people. She attended nursing school in Arizona just as the field was transitioning from a purely hospital-based program at Good Samaritan Hospital, to a burgeoning academic program at Arizona State University. This meant that Lattimer, in one of the university's first nursing classes, had to balance full time hospital training with a three-year college program. "It was probably a lot more grueling than just doing four years at a university, to pair those college courses with the amount of time we were at the hospital."

 

She worked first in hospitals, and then for "general practice" physicians in the 1970s. As the physicians she worked for began to retire, Lattimer found herself yearning for a new area in which to spread her wings. She worked not only in healthcare, but also for a time with the adoption group All God's Children. Through all her work in and out of the healthcare system, Lattimer said the need for coordinated care was becoming increasingly apparent.

 

Her passion for case management was born from her work on both the medical and behavioral health sides of healthcare, and the intense need for case management in the instances the two sides overlap. "Patients come to us, not with separate personalities, but as one individual suffering both of these, medical and behavioral problems. So complex medical case management became a passion of mine."

 

"The more that I worked in and out of the United States and for different healthcare systems, the more I realized that the common denominator in everything that we do in healthcare is the patient and their families," she said. "They often get left in a dark area, if you will, trying to figure out how to get through, get to resources, get to the care they need. The sicker they are, the more diseased the state, the more comorbidities they have, the more doctors they see and the more medications they take, so the more complicated this becomes."

 

Over the last 10-15 years, Lattimer said she has worked closely with colleagues developing curricula that helps case managers, nurses and social workers feel comfortable dealing with both the medical and behavioral side of these complex cases. She has even worked with programmers developing software to provide better case management tools for use in all sorts of healthcare settings.

 

Another force driving her from the clinical side into this executive role was the change in the healthcare industry itself. Increasingly shorter hospital stays combined with an increased number of issues surrounding payment and insurance translates into sicker patients being moved out of the hospitals quicker, she said. "That really drove me past the clinical side into more administrative concerns, technology development, and most recently in this position, public policy."

 

Though she and her husband Gill, a retired Army officer, enjoy a number of activities around their new home in Little Rock, lately Lattimer has been spending more time in the nation's capital than in Arkansas'. Her job is to make sure that as they debate and shape healthcare reform, legislators are educated as to what case managers are and what they do to smooth the sometimes maddeningly complicated process of healthcare navigation.

 

"As we look at the things we see coming as far as healthcare reform and improvement, and at new performance measures around care coordination and transitions of care, case managers will play a very definite role in being able to assist and help achieve those performance measures," she explained. Case managers are true collaborators with physicians, nurses, social workers, pharmacists and other team members, she said, and are there to support the entire team and enhance communication both within the team and with the patients and their families, and provide a level of care coordination that other team members rarely have time to provide.

 

Ironically, while she said case management is "very well represented" in Arkansas, the biggest gap is with the people who most benefit from case management: the patients. "Oftentimes, patients have no idea to ask for a case manager or ask their insurer about case management," she said. "It's up to the healthcare team to let them know."

 

Besides CMSA, Lattimer works closely with the National Transitions of Care organization. She encourages healthcare providers of all types to take advantage of the numerous free resources NTOC offers. "We have materials downloaded from that site from 31 countries," she said. "That shows that transitions of care and care coordination isn't just a U.S. concern, it's a human concern."

 

When she's not traversing the country on speaking engagements and conferences, Lattimer said she and Gill enjoy spending time with their five grown children and nine grandchildren, or hiking, golfing, or traveling for leisure. After a long day of advocacy and education, quiet activities like sewing and reading relax her, as does music. She sings and plays guitar, piano, and even though she rarely admits it publicly—accordion.