The focus of this paper is case management. Case management has evolved into a diverse profession which includes many disciplines and is exercised in many settings. Case management involves the process of coordinating multiple services on behalf of clients and has been practiced now for several decades. Many disciplines have engaged in case management and identify themselves as case managers. Case managers work with many populations and settings and play an important role in today’s society. The following analysis explores how case management developed, how it is defined, its components, and how it relates to other nursing care delivery models. All these aspects are reviewed with the purpose to show the importance of case management in the health care organization. Case Management Case management has become the standard method of managing health care delivery organizations today. In recent decades, case management has become widespread throughout healthcare areas, professionals, and models in the United States; and has been extended to a wide range of clients (Park & Huber, 2009). Regardless of the setting, case management ensures that care is oriented to the client, while controlling costs at the same time. Case management delivers quality care to patients in the most cost effective approach by managing human and material resources. Client advocacy is a strong underlying theme for all case management activities. Case managers share the same goals and standards of practice, but are multidisciplinary and have diverse academic educational backgrounds and work environments (Park & Huber, 2009). The need for case management and case managers continue to increase as new service needs, and populations are recognized.... ... middle of paper ... ...jured, chronically ill, and high cost cases (Jacob & Cherry, 2007). Conclusion Only within recent decades case management has been introduced, but has been proven to be a significant segment of the healthcare workforce today. There have been several changes to case management over the last few decades, and the future for case management is very diverse. Case management offers many benefits to both the client and the health care organization. In addition, case management plays a key role in a client’s road to recovery. Most importantly, case managers have a vital role overseeing their client’s transition from the hospital setting back into the community and ensuring all service needs are met. Moreover, the opportunities and need for case managers working with many populations and settings are great, and may ultimately lead to better health for individuals.
The Claims and Patient Business Services departments have made remarkable strides on getting back on track due to these changes, which has provided much needed relief to the MSD. However, MSD is still struggling, on the other hand, with a few issues such as high absenteeism and low morale which makes it difficult to balance available staff with incoming call load. There are also a few factions that are often found socializing in other people’s cubicles or going to the lobby to take personal phone calls. Lastly, there has also been difficulty within the management team as a result of both past and future management styles within the department.
- Wolper, Lawrence F. Health Care Administration: Planning, Implementing, and Managing Organized Delivery Systems. Gaithersburg, MD: Aspen, 1999
Studies indicate that nurse case management has reduced patient readmissions to the hospital and improved patient’s overall health. Case management uses assessment, planning, facilitation, coordination, and advocacy to meet the needs of the patient and family/caregiver (CMSA, 2014). Using a holistic and patient-centered approach, case managers can address each patient’s specific needs. Communication is vital between the patient/family, physician, case manager, and others departments involved in the care. The five principles that case management functions under include: 1) focus on the patient and family, 2)
The Crowded Clinic Case Study (Colorado State University - Global, n.d.) discusses the issues of practice management as they apply to access to care. Access to care may be as inconvenient as lengthy patient wait times to issues far more serious that may have a profound effect on the health and well-being of a single patient or an entire cohort.
Case managers are collaborative members of the health care team which promote better communication with provider, and advocates for implementation of care plans (effective health care).
Case conceptualization and treatment planning is used by therapist to assist in determining a client’s diagnosis, goals, and treatment plan that is most effective in determining the issues surrounding the clients diagnosis. It is crucial that the client’s treatment plan is specific to the individual, is relational and appropriate to the needs of the client.
Case conceptualization explains the nature of a client’s problem and how they develop such problem ( Hersen, & Porzelius, p.3, 2002) In counseling, assessment is viewed as a systematic gathering of information to address a client’s presenting concerns effectively. The assessment practice provides diagnostic formulation and counseling plans, and aids to identify assets that could help the client cope better with concern that they are current. Assessment is present as a guide for treatment and support in the “evaluation process. Although many methods can be employed to promote a thorough assessment, no one method should be used by itself” (Erford, 2010, p.269-270). Eventually, it is the counselor's job to gain adequate information concerning the client and the client's presenting concerns to establish an effective treatment strategy. Using a combination of assessment techniques increases the likelihood of positive interventions and promotes successful treatment (Erford, 2010, p.271). A case conceptualization reflects how the professional counselor understands the nature of the presenting problems and includes a diagnostic formulation. Case conceptualization organizes assessment data into meaningful outline, applying research, and theory to make sense of client’s current problem.
...s and what and how they feel about the services of case managers. Provides comprehensive overview of consumers opinions to help in quality service.
Three areas that define the provisions of comprehensive health care services and are commonly used for utilization monitoring and control are gatekeeping, case management, and utilization review (UR). Gatekeeping is used by HMOs where each member designates a primary care provider (PCP) that is responsible for coordinating all care services needed for the enrollee in a managed care plan. Case management involves an experienced health care professional with knowledge of available health care resources. `Case management services are designed to identify spec...
Nursing staff, Social Workers, and case managers play an important role in the discharge planning which also correlates with patient safety outcomes. Case managers and social workers work face to face with...
According to the Case Management Society of America, case management is "a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost effective outcomes" (Case Management Society of America [CMSA], 2010). As a method, case management has moved to the forefront of social work practice. The social work profession, along with other fields of study, recognizes the difficulty of locating and accessing comprehensive services to meet needs. Therefore, case managers work with these Case management is a problem-solving practice method that has had a growing momentum over time. This is due in part to federal and state funded program mandates and the desire for continuity of care.
Case management has become the standard method of managing health care delivery systems today. In recent decades, case management has become widespread throughout healthcare areas, professionals, and models in the United States; and it has been extended to a wide range of clients (Park & Huber, 2009). The primary goal of case management is to deliver quality care to patients in the most cost effective approach by managing human and material resources. The focus of this paper is on the concept of case management and how it developed historically, the definition of case management, the components of case management, and how it relates to other nursing care delivery models.
My understanding of case management comes from an accumulation of lecture, readings, and a little bit of research. At first I thought case management meant to manage a case, which it kind of does, but it is a lot of background work that goes unnoticed from the workers part. One thing for sure I can say about case management is that is a very stressful and demanding job for the worker, therefore, you have to be a responsible worker, so that your client can hopefully get the services and resources he or she may need. As a case management worker your responsibilities are many, for example you are to educate, empower and enable your client to be self sufficient.
According to IC & RC, Case Management is defined as, “activities intended to bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts” (Herdman, John W., 6th Edition). Case management is a concerted effort of various professionals in the human social services network that assess’, plans, implements, coordinates,
The synopsis of the summary clearly describes that there is an issue with nursing care. The main issue is that there are unfinished nursing care. In the medical field, nurses are predominantly responsible for maintain quality care for the patient. Because they are predominantly responsible, the issue lies that nursing care is not the way it should be. The outcomes are declining and nurses often lack the time to care for their patient which cause a major declension in patient’s health.