Case Management Techniques Research Articles

Exploring Reasons for Non-Engagement From a Peer-Led Diversionary Intervention for Veterans in Police Custody.

UK veterans with complex needs arrested in police custody can access support through pre-charge diversion into treatment and ancillary services. We consider why veterans in police custody disengaged from a peer-led criminal justice diversionary support service in one UK region that adopted a continuous case management approach. Seven hundred and fifty-seven veterans were assessed to have high levels of comorbid health needs and socio-economic harms, with one-quarter (26.7%, n = 202) subsequently disengaging from the service. A logistic regression model using Multivariate Imputation by Chained Equations identified that veterans of a younger age, no-fixed-abode, a history of incarceration, and those from a Royal Navy background were likelier to disengage from the intervention. We conclude that this peer-based diversionary model has some efficacy in maintaining the engagement of a highly complex, comorbid segment of criminally-justice-exposed UK military veterans. The perceived benefits of an integrated peer-based model predicated on continuous case-management techniques are discussed.

More Talk, Less Conflict: Evidence from Requiring Informal Discovery Conferences

Abstract Discovery is the formal process of exchanging information under the supervision of the courts. Since managing discovery is costly, courts have implemented case management techniques to reduce motion practice in discovery. This study examines whether case management techniques can reduce the likelihood of a discovery dispute. We attempt to untangle the impact of specific judges from the use of a particular case management technique. We focus on the use of informal discovery conferences (IDCs) in which parties meet with the judge before filing a motion to compel. The problem with simply testing whether IDCs reduce the number of discovery motions is that the use of an IDC is likely endogenous. Our solution to this endogeneity is to use the random assignment of judges. Since some judges have a higher propensity to use IDCs and some courts have begun requiring them, we have two sources of policy variation. Using this estimation strategy, we find that IDCs reduce the number and presence of discovery motions. (JEL K13, K40, K41)

EXPEDITIOUS DISPOSAL OF CASES BY EMPLOYING THE TECHNIQUES OF CASE MANAGEMENT, PRE-TRIAL REVIEW AND ADR

Every institution is important for the functioning of a democracy, but the judiciary’s role is even more vital as it bears the onerous responsibility of dispensing justice across society. However, owing to public inclination towards litigation, the need for judicial attention will always outweigh the availability of its time. Delay in disposal of cases is widespread in most of the states and Pakistan is no exception. However, procedures are being developed to draw maximum benefit out of the available judicial time. Most of these procedures apply case management techniques to fairly distribute judicial time to different kinds of cases depending on their specific requirements. Obviously, not all cases or stages within those cases require equal amount of judicial attention, case management techniques require us to prioritize cases in order of their complexity, so that each category may be assigned the amount of time and attention it deserves from a judge. Delay in disposal of cases is the result of several variables that are intricately interconnected. In an ideal world, justice should be administered swiftly, but in practice, there can be hurdles in the way of this outwardly simple goal. Aa an example, attorneys would constantly ask for adjournments on one pretext or the other. Judges, on their part, would happily grant their requests to ease their workload. Likewise, never-ending cross examinations and lengthy arguments make it even harder to dispose of a case, not to speak of time spent by judges on writing judgments and coming to terms with miscellaneous applications and administrative work. While there is nothing much that can be done concerning dilatory tactics of lawyers, a lot can, however, be done about efficient management of judicial time. The three most frequently employed techniques are Pre-Trial Review, Differentiated Case Management (DCM) and Alternate Dispute Resolution (ADR). According to UNODC’s Best Practices Guide, by adopting these, time spent on disposal of a case can be brought down to one third. It is reassuring to note that case management techniques are being put to practice in Pakistan by introducing legislation, such as the Punjab Alternate Dispute Resolution Act, 2019. However, the public is still inclined towards litigation. Perhaps, one of the reasons is court driven rather than the community centric nature of our case management techniques. Keywords: Justice, ADR, ex-parte, administrative meetings, adjournments, litigation.

Laboratory Evaluation and Field Testing of Dengue NS1 and IgM/IgG Rapid Diagnostic Tests in an Epidemic Context in Senegal.

In Senegal, the burden of dengue is increasing and expanding. As case management and traditional diagnostic techniques can be difficult to implement, rapid diagnostic tests (RDTs) deployed at point of care are ideal for investigating active outbreaks. The aim of this study was to evaluate the diagnostic performance of the Dengue NS1 and Dengue IgM/IgG RDTs on the serum/plasma samples in a laboratory setting and in the field. During laboratory evaluation, performance of the NS1 RDT was assessed using NS1 ELISA as the gold standard. Sensitivity and specificity were 88% [75-95%] and 100% [97-100%], respectively. Performance of the IgM/IG RDT was assessed using the IgM Antibody Capture (MAC) ELISA, indirect IgG, and PRNT as gold standards. The IgM and IgG test lines respectively displayed sensitivities of 94% [83-99%] and 70% [59-79%] and specificities of 91% [84-95%] and 91% [79-98%]. In the field, the Dengue NS1 RDT sensitivity and specificity was 82% [60-95%] and 75% [53-90%], respectively. The IgM and IgG test lines displayed sensitivities of 86% [42-100%] and 78% [64-88%], specificities of 85% [76-92%] and 55% [36-73%], respectively. These results demonstrate that RDTs are ideal for use in a context of high prevalence or outbreak setting and can be implemented in the absence of a confirmatory test for acute and convalescent patients.

One size fits all An analytical approach how to make use of process modelling techniques for different fundamental supply chain types

Process orientation is considered a key driver for the efficiency and effectiveness of modern supply chains. It is recognised in science and practice that the modelling of logistics processes is the first step in their optimisation. At the same time, well-known process modelling techniques are not suitable for every type of supply chain. This article uses two established frameworks to make recommendations regarding which modelling technique fits to which supply chain type. For example, BPMN or BPMN light can help lean processes, while flexible and collaborative supply chains more likely require BPM 2.0 and case management techniques. Practitioners can use these findings to apply the most promising process management technique for their business purposes. From the scientific point of view, this article focuses on the integration and process orientation of supply chains and fosters with it the necessity of corporate customer-centricity.

Utilizing Actionable Data Analytics to Support Patient Navigation Enrollment and Retention Within Federally Qualified Health Centers.

Emergency departments (EDs) have become the primary source of care for increasing number of patients, leading to treatment of nonemergent cases, which divert resources from true emergency situations and represent poor cost-effectiveness for treating such cases. There is evidence that suggests that patient navigation (PN) integrated into the ED and other case management techniques can help reduce the number of primary care-related ED visits and these navigation programs are more cost-effective than the ED visits themselves. The Greater New Orleans Community Health Connection Primary Care Capacity Project Quality Improvement Initiative (GNOPQii) is a pilot project aimed at improving the efficiency of PN for patients who have had avoidable ED encounters or inpatient readmissions through applied data and technology program. Partnering Federally Qualified Health Centers were equipped with actionable ED utilization data to integrate with their own patient clinical data to track patient ED activity. The pilot design also included the use of patient navigators to address the nonclinical cultural and behavioral barriers to care. As part of the overall evaluation, comparisons of data utilization and PN services pre- and post-GNOPQii were conducted. A total of 337 referrals were made, and 145 patients were enrolled into the GNOPQii pilot program. The direct services needed the most by patients were transportation and medication resources. Of those who enrolled (N = 145), 63 patients graduated, meaning program compliance and 90 days without visits to the ED, resulting in a 43% success rate. If an estimated $1898 savings for every nonemergency ED encounter replaced by an office-based encounter is applied to our results, the GNOPQii program contributed to a minimum of $119 574.00 savings even if only 1 deterred ED visit per graduate is assumed. Future research is needed to systematically test the efficacy of GNOPQii in reducing nonemergent ED visits.

Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use: A Randomized Clinical Trial.

Substance use is a major driver of the HIV epidemic and is associated with poor HIV care outcomes. Patient navigation (care coordination with case management) and the use of financial incentives for achieving predetermined outcomes are interventions increasingly promoted to engage patients in substance use disorders treatment and HIV care, but there is little evidence for their efficacy in improving HIV-1 viral suppression rates. To assess the effect of a structured patient navigation intervention with or without financial incentives to improve HIV-1 viral suppression rates among patients with elevated HIV-1 viral loads and substance use recruited as hospital inpatients. From July 2012 through January 2014, 801 patients with HIV infection and substance use from 11 hospitals across the United States were randomly assigned to receive patient navigation alone (n = 266), patient navigation plus financial incentives (n = 271), or treatment as usual (n = 264). HIV-1 plasma viral load was measured at baseline and at 6 and 12 months. Patient navigation included up to 11 sessions of care coordination with case management and motivational interviewing techniques over 6 months. Financial incentives (up to $1160) were provided for achieving targeted behaviors aimed at reducing substance use, increasing engagement in HIV care, and improving HIV outcomes. Treatment as usual was the standard practice at each hospital for linking hospitalized patients to outpatient HIV care and substance use disorders treatment. The primary outcome was HIV viral suppression (≤200 copies/mL) relative to viral nonsuppression or death at the 12-month follow-up. Of 801 patients randomized, 261 (32.6%) were women (mean [SD] age, 44.6 years [10.0 years]). There were no differences in rates of HIV viral suppression versus nonsuppression or death among the 3 groups at 12 months. Eighty-five of 249 patients (34.1%) in the usual-treatment group experienced treatment success compared with 89 of 249 patients (35.7%) in the navigation-only group for a treatment difference of 1.6% (95% CI, -6.8% to 10.0%; P = .80) and compared with 98 of 254 patients (38.6%) in the navigation-plus-incentives group for a treatment difference of 4.5% (95% CI -4.0% to 12.8%; P = .68). The treatment difference between the navigation-only and the navigation-plus-incentives group was -2.8% (95% CI, -11.3% to 5.6%; P = .68). Among hospitalized patients with HIV infection and substance use, patient navigation with or without financial incentives did not have a beneficial effect on HIV viral suppression relative to nonsuppression or death at 12 months vs treatment as usual. These findings do not support these interventions in this setting. clinicaltrials.gov Identifier: NCT01612169.

The Role of Judges in the Performance of Italian Courts

<p class="ber"><span lang="EN-US">The paper analyses the contribution judges make to the supply of justice in Italian district courts. A </span><span lang="EN-GB">Multilevel Growth Model (</span><span lang="EN-GB">MGM) </span><span lang="EN-US">was applied to the analysis. The results show several differences in productivity in Italian district courts, which may be linked to (i) differences in the contribution of judges (ii) poor rational organization of resources and/or (iii) a</span><span lang="EN-GB"> limited use of case management techniques. </span></p>

Effectiveness of a primary care based complex intervention to promote self-management in patients presenting psychiatric symptoms: study protocol of a cluster-randomized controlled trial

BackgroundAnxiety, Depression and Somatoform (ADSom) disorders are highly prevalent in primary care. Managing these disorders is time-consuming and requires strong commitment on behalf of the General Practitioners (GPs). Furthermore, the management of these patients is restricted by the high patient turnover rates in primary care practices, especially in the German health care system.In order to address this problem, we implement a complex, low-threshold intervention by an Advanced Practice Nurse (APN) using a mixture of case management and counseling techniques to promote self-management in these patients. Here we present the protocol of the “Self-Management Support for Anxiety, Depression and Somatoform Disorders in Primary Care” (SMADS)-Study.Methods/DesignThe study is designed as a cluster-randomized controlled trial, comparing an intervention and a control group of 10 primary care practices in each case. We will compare the effectiveness of the intervention applied by an APN with usual GP-care. A total of 340 participants will be enrolled in the study, 170 in either arm. We use the Patient Health Questionnaire-German version (PHQ-D) as a screening tool for psychiatric symptoms, including patients with a score above 5 on any of the three symptom scales. The primary outcome is self-efficacy, measured by the General Self-Efficacy Scale (GSE), here used as a proxy for self-management. As secondary outcomes we include the PHQ-D symptom load and questionnaires regarding coping with illness and health related quality of life. Outcome assessments will be applied 8 weeks and 12 months after the baseline assessment.DiscussionThe SMADS-study evaluates a complex, low threshold intervention for ambulatory patients presenting ADSom-symptoms, empowering them to better manage their condition, as well as improving their motivation to engage in self-help and health-seeking behaviour. The benefit of the intervention will be substantiated, when patients can enhance their expected self-efficacy, reduce their symptom load and engage in more self-help activities to deal with their everyday lives. After successfully evaluating this psychosocial intervention, a new health care model for the management of symptoms of anxiety, depression and somatoform disorders for ambulatory patients could emerge, supplementing the work of the GP.Trial registrationClinicaltrials.gov Identifier: NCT01726387

Krankenkassengestütztes Case-Management verbessert kostenneutral die Behandlungsqualität bei affektiven Störungen

Improvement of depression treatment by health insurance based case-management. Criteria of improvement were a higher treatment rate of patients suffering from affective disorders or depression by psychiatrists or psychotherapists than by general practitioners or family doctors and sickness fund payments. Training of health insurance account managers (characteristics of depression, counselling and, case management techniques). Evaluation of outcomes during 12-months against a control group of account managers without training. Intervention group: 87.8 % patients with in average 13.5 contacts to psychiatrists or psychotherapists; control group: 82.6 % patients with 11.8 contacts. The difference was statistically significant. Health insurance payments did not differ. A higher treatment rate by psychiatrists and psychotherapists can be achieved by health insurance-based case-management without a cost-increase.

The 2012 ICC Rules of Arbitration – An Accelerated Procedure and Substantial Changes

The 2012 International Chamber of Commerce (ICC) Rules of Arbitration pave the way for more expeditious arbitral proceedings since under the added requirements, the parties are to provide more extensive information during the initial stages of the proceedings. The delays caused by further submissions are thereby avoided. A wider approach towards the case, may enable the joinder of additional parties, to address claims between multiple parties and multiple contracts ab initio, and to consolidate arbitration proceedings. The new Rules establish an emergency arbitrator procedure for urgent interim or conservatory measures, as well as case management techniques to reduce the costs. The work of the members of the ICC Commission of Arbitration, the ICC National Committees, the International Court of the Arbitration, the representatives of the National Committees, and selected counsels and arbitrators, over a two-year period bore results: in June 2011 in Mexico City, a revised version of the 1998 ICC Rules of Arbitration was adopted by The World Council of the ICC (hereinafter 'the 2012 ICC Rules' and/or 'the new Rules').

The proposed national mental health law in China: a landmark document for the protection of psychiatric patients' civil rights.

The proposed national mental health law in China: a landmark document for the protection of psychiatric patients' civil rights.

Role of Communities in Resource Mobilization and Risk Sharing: A Synthesis Report

Most community finance schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Usually government taxation capacity is weak, formal mechanisms of social protection for vulnerable populations absent, and government oversight of the informal health sector lacking. In this context of extreme public sector failure, community involvement in financing health care provides a critical though insufficient first step in the long march toward improved access to health care by the poor and social protection against the cost of illness. It should be regarded as a complement to-not as a substitute for-strong government involvement in health care financing and risk management related to the cost of illness. Based on an extensive survey of the literature, the main strengths of community financing schemes are the extent of outreach penetration achieved through community participation, their contribution to financial protection against illness, and increase in access to health care by low-income rural and informal sector workers. Their main weaknesses are the low volume of revenues that can be mobilized from poor communities, the frequent exclusion of the very poorest from participation in such schemes without some form of subsidy, the small size of the risk pool, the limited management capacity that exists in rural and low-income contexts, and their isolation from the more comprehensive benefits that are often available through more formal health financing mechanisms and provider networks. The authors conclude by proposing concrete public policy measures that governments can introduce to strengthen and improve the effectiveness of community involvement in health care financing. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) use of insurance to protect against expenditure fluctuations and use of reinsurance to enlarge the effective size of small risk pools; (c) use of effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks.

Effectiveness of community health financing in meeting the cost of illness.

How to finance and provide health care for the more than 1.3 billion rural poor and informal sector workers in low- and middle-income countries is one of the greatest challenges facing the international development community. This article presents the main findings from an extensive survey of the literature of community financing arrangements, and selected experiences from the Asia and Africa regions. Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Micro-level household data analysis indicates that community financing improves access by rural and informal sector workers to needed heath care and provides them with some financial protection against the cost of illness. Macro-level cross-country analysis gives empirical support to the hypothesis that risk-sharing in health financing matters in terms of its impact on both the level and distribution of health, financial fairness and responsiveness indicators. The background research done for this article points to five key policies available to governments to improve the effectiveness and sustainability of existing community financing schemes. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) insurance to protect against expenditure fluctuations and re-insurance to enlarge the effective size of small risk pools; (c) effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks.

Community matrons and long-term conditions: an inside view

This paper sets out to assess the impact of the community matron as perceived by those undertaking this relatively new nursing role. With the incidence of people living with long-term conditions continuing to rise and subsequently the costs of care set to increase, the role of community matron was identified as one approach to improve the management of these individuals living with chronic conditions. This included anticipating, coordinating and joining up care of specific high intensity patients with complex long-term conditions while supporting new ways of working to reduce unplanned hospital admissions and contain costs. Local primary care trusts (PCTs) were given guidance for the development of the community matron role with supporting frameworks for competency expectations and the use of case management techniques along with targets to achieve and a minimum case load criteria. Following the implementation of this role in 2005 a small scale study was conducted to evaluate the role using nine community matron participants working across NHS South of Tyne and Wear PCTs. Following in-depth interviews results were analysed and findings suggestive of many positive aspects of the role and areas still requiring further support and development.

Classless Not Clueless: A Comparison of Case Management Mechanisms for Non-Class-Based Complex Litigation in California and Federal Courts

In this comparison of non-class-based complex litigation in California and federal courts, Scott Paetty examines the case management strategies employed in California's complex court system and in the federal multidistrict litigation process. Evaluating the strengths and weaknesses of both systems, Paetty describes what makes a case complex, evaluates procedural mechanisms for dealing with complex cases, and then discusses some of the informal case management techniques practiced by judges in both systems. Paetty ultimately finds the flexible approach advanced in the California complex court system to be more effective and argues California's system should be a model for other states seeking to manage complex cases.

From Diseased towards Human Ease

A long-term difficult case involving multiple disease layers demonstrating clearly the need for a comprehensive case management approach and the use of more than one remedy. Treating episodic acute illness within the framework of chronic disease involves addressing the underlying miasmic influence. Different case management techniques and remedies illustrated, analyzed and compared. Appropriate usage of hand-triturated, high-potency (C 4, C 5) remedies. The treatment of addiction via the patient's trituration of the addictive substance (tautopathy). Following the sensation, the patient and the energy of the case to bring about a curative response. Remedies used include Falco-p, Merc, Ativan, Calc-p, Lac-h, and Umbilical cord.

From Diseased towards Human Ease

Long-term difficult case involving multiple disease layers demonstrating clearly the need for a comprehensive case management approach and the use of more than one remedy. Treating episodic acute illness within the framework of chronic disease involves addressing the underlying miasmic influence. Different case management techniques and remedies illustrated, analyzed and compared. Appropriate usage of hand-triturated, high-potency (C4, C5) remedies. The treatment of addiction via the patient's trituration of the addictive substance (tautopathy). Following the sensation, the patient, and the energy of the case to bring about a curative response. Remedies used include Falco-p, Merc, Ativan, Calc-p, Lac-h, and Umbilical cord.

Lived Experiences of Vulnerability in the Childhood of Persons Recovering from Substance Abuse

• Summary: The aim of the study was to deepen understanding of the context of vulnerability which is associated with drug-taking behaviour and addiction. The researchers sought to identify recurring psychosocial and environmental factors in the childhood and early adulthood backgrounds of the participants. They further scrutinized the data for pairs or co-occurrences of such risk factors across the target groups. Qualitative methodology was employed, based on in-depth interviews. The participants were accessed in drug rehabilitation centres in Trinidad and in Barbados, bringing a cross-national dimension to the work. The Qualitative Comparative Analysis (QCA) method was used to analyse the data. • Findings: It is significant that nearly half of the Trinidad group and two-thirds of the Barbados group reported experience of rejection or abandonment in childhood. A profile of stressful or traumatic experiences was compiled for each participant, from which it was possible to identify co-ocurring pairs of stressors, which suggest inter-relationships between the phenomena. Marked co-occurrence was found between domestic violence and alcoholism; domestic violence in the participants' family background and non-attainment of. Secondary School Certification; non-attainment of Secondary School Certification and rejection; poverty and rejection; domestic violence and rejection. • Applications: Case management techniques can benefit from research-generated insights on interrelationships between critical risk-connected phenomena, especially in developing concerted approaches to problems of substance abuse using preventive techniques.

Patent Case Management Judicial Guide

As the number, size, and complexity of patent cases have grown throughout the United States over the past several decades - paralleling expansion in the role of high technology enterprises in the U.S. economy - the need for a comprehensive, user-friendly, and practical judicial guide for managing patent cases has become increasingly apparent. Although similar in many respects to other forms of complex civil litigation, patent cases pose distinctive case management challenges. Patent cases feature complex and dynamic technological facts to a degree rarely encountered in most other areas of litigation. Furthermore, they employ unique procedures (such as claim construction hearings) that affect and interact with other aspects of the case (such as summary judgment motions and expert reports) in ways that create unusual scheduling and substantive complexity. In addition, patent cases often entail distinctive and difficult discovery issues, extensive use of experts, and particularly complex dispositive and pre-trial motion practice.Because of the decentralized, general jurisdiction structure of federal courts in the United States, much of the experience relating to managing patent cases is silo-ed in particular judicial chambers. As one jurist aptly noted, best practices for patent case management have been transmitted largely through word of mouth. Given the crowded, diverse dockets of federal courts, the accessibility and reliability of such knowledge is far from ideal. Judges in some districts have partially codified recommended practices in the form of Patent Local Rules, standing orders, and patent jury instructions, but these documents do not address the full range of distinctive challenges posed by patent litigation. Furthermore, such judicial wisdom continues to evolve. Recognizing these patterns, the authors undertook in 2006 to survey the range of approaches and perspectives on patent case management, foster discussion and analysis of patent case management techniques, and develop an authoritative guide for judges, law clerks, practitioners, and patent and civil procedure professors and scholars. Given the dynamism of the patent system and patent litigation, the authors plan to revise the Guide on a biennial basis.