No matter how positive a patient's hospital experience is, the goal is always for that patient to be discharged.

Thinking through the details that will keep a patient progressing in his or her recovery after a hospital stay is the focus of Isabella Clemente's work as an RN Case Manager for Spotsylvania Regional Medical Center.

Clemente's case management work is focused on the surgical unit, emergency department and post-anesthesia care unit.

As she works with patients who have undergone joint, spinal or abdominal surgeries, or even simpler procedures such as a cyst removal, she helps ease their minds, and those of their family and caregivers, as they prepare to continue their healing when they leave the hospital.

"We make sure everything is set up when the patient leaves so that they can continue their recovery," Clemente says.

Clemente has more than 40 years of nursing experience, and has worked in the Fredericksburg region for more than 15 years. In her work, she draws on that experience--and the contacts she's made with organizations within the Fredericksburg community that share her desire to help people improve their lives.

"I love helping those who need to be helped, and trying to make their life better in some way," says Clemente, who over the years has supported community organizations such as Empowerhouse and Mary's Shelter, and regularly participates in walks for suicide prevention, lymphoma, leukemia and other causes.

Clemente likes the small-town feel of Fredericksburg, where she enjoys strolling the historic downtown in her time off from work.

"Everybody gets to know each other," she says, "and the agencies are wonderful--if they cannot assist you, they refer you to someone who can. There is a lot of collaboration."

The desire to improve the lives of others is a common thread that runs through the Case Management department at Spotsylvania Regional Medical Center, a team Clemente says works together as closely as a family.

"We are all resources for each other, we chip in and help each other," she says.

Every morning includes a team meeting where case managers go over every case in the hospital. Clemente says this helps the team to contribute expertise from their various specialties. It's a chance to talk through what services might be needed or beneficial to patients when they are released from the hospital--everything from nutrition services to physical or occupational therapy, speech pathology, in-home healthcare or referral to a rehabilitation center.

Case managers think through every detail, down to the logistics of how a patient will get prescriptions filled, and whether an individual can afford them or may need assistance.

"We put everything in place, so all the patient has to be concerned about is getting better, recovering, and getting back to where they were prior to their surgery," she says. "It's just taking away all their fears and worries and saying, 'You just recover.'"

Clemente enjoys the supportive environment at Spotsylvania Regional Medical Center, where she feels like the top administrators are available and open to ideas from staff at all levels about how to create better experiences and outcomes for patients.

Case management, she says, carries that quality of care beyond the hospital stay.

"It closes the circle on the care we provide here at Spotsylvania Regional Medical Center," she says. "Of course, the circle is never fully closed because we are always available, and we want our patients to have such exceptional care and follow-up that if they do have a need in the future, we would hope they would return to us."

Isabella Clemente standing in an office
Clemente's case management work is focused on the surgical unit, emergency department, and post-anesthesia care unit.