Definition And Philosophy Of Case Management Case Study

Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. A Case Manager is a person (as a social worker or nurse) who assists in the planning, coordination, monitoring, evaluation of medical services for a patient with emphasis on quality of care, continuity of services, and cost-effectiveness. ("Definition and Philosophy of Case Management", 2015). For the past 18 years Gloria Bagnerise has been a dedicated registered nurse with five years of experience currently

Gloria possesses a strong background in hospice triage and as a vocational nurse clinical/skill instructor. Gloria has experience delivering CPR training programs to staff and students. In addition, Gloria has a strong background in computer skills, managing heavy daily patient volume, appointments, scheduling, and patient referrals. She contributes her success in her occupation to the education she has received, but mostly from her experiences working as a registered nurse. A typical day of a case manager includes developing and modifying plans of care, conducting and attending team meetings, completing home and vocational visits, computer input and documentation, client referrals, scheduling meetings. No two days are ever the

Auslander and Carneal, JD, MA (2014) Important issues facing case managers today are transition of care, accountable care organizations, expanded health insurance coverage, and implementation challenges to name a few. PPACA has important goals of easing patient transitions and decreasing readmission. Case managers are impacted by this because they are charged with the education and support of patients through coordinating effective care as the patient moves through the healthcare continuum. Implementing the changes mandated by PPACA can be difficult. Patients experienced problems with the public enrollment efforts which created some distrust of the PPACA and new programs. Expanded health coverage has resulted in an additional 25 million Americans with healthcare coverage. (Auslander & Carneal, JD, MA, 2014) it will require a case managers to educate and manage these patients on a much larger scale, while there is a shortage of nurses in the healthcare industry. Continuity of care then becomes a concern for the case manager. Case managers are now an integral part of the solution as Congress and others address specific healthcare reform