The development of a preliminary taxonomy on case management of brain injury for a common language

Abstract

Introduction: Case management (CM) is a key element of integrated care and makes a unique contribution towards improved functioning and community participation of a person with a complex health condition. However, there is a dearth of information and international consensus on the definition and components of CM. The need for common language and clarity about what is, and is not case management was the impetus for the development of a preliminary taxonomy on case management for persons with brain injury or spinal cord injury. Method: The development of the brain injury CM preliminary taxonomy (BICM-PT) occurred in five phases. Phase 1 involved a systematic search and review of the case management literature to extract information on the components, activities and descriptors of CM. Phase 2 was a critical review of appropriate frameworks to inform the structure of the taxonomy. Phase 3 involved Iterative development and refinement of the draft taxonomy with a nominal group of experts in case management. Phase 4 involved mapping the actions, main actions and related actions of the draft taxonomy to the International Classification of Health Interventions (ICHI ) (Paviot et al, 2011) to identify the alignment and gaps. Phase 5 involved mapping the ‘main types of care’ (MTCs) of CM to the international classification of services DESDE-LTC (Salvador-carulla et al, 2013). Results: The BICM-PT beta 1 developed following Phase 1 and 2 included 12 actions and more than 50 components. In the beta 2 version, the nominal group of multi-disciplinary expert case managers who work with children, adults in both urban and regional areas and different service contexts, refined the taxonomy to 13 actions and 37 components. The mapping to ICHI (Phase 4) involved further refinement to 9 actions: engage with the client, holistic assessment, planning, education, training and skills development, emotional and motivational support, advising, coordinating, monitoring. The actions include 28 components and a series of extensions or qualifiers. Three new MTCs were added to the branch A4 (Care coordination) of the DESDE-LTC classification of services to fully describe the main types of care with CM.