Professional Case Management Research Articles

COLLABORATE©

Professional Case Management: January/February 2014 - Volume 19 - Issue 1 - p 16-17 doi: 10.1097/NCM.0000000000000014

COLLABORATE©

The purpose of the third of this 3-article series is to provide context and justification for a new paradigm of case management built upon a value-driven foundation that * improves the patient's experience of health care delivery, * provides consistency in approach applicable across health care populations, and * optimizes the potential for return on investment. Applicable to all health care sectors where case management is practiced. In moving forward the one fact that rings true is there will be constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby or Pokey. This is exactly why the definition of a competency-based case management model's time has come, one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. While there is inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

The Role and Contributions of Geriatric Care Managers

Professional Case Management: November/December 2013 - Volume 18 - Issue 6 - p 293-294 doi: 10.1097/NCM.0000000000000000

Another Look at Roles and Functions

Professional Case Management: September/October 2013 - Volume 18 - Issue 5 - p 255-256 doi: 10.1097/NCM.0b013e3182a27d1c

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The purpose of this second article of a 3-article series is to clarify the competencies for a new paradigm of case management built upon a value-driven foundation that : Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is that there will be a constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby™ or Pokey™. This is exactly the time to define a competency-based case management model, highlighting one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. Although there is an inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

Designing the Role of the Embedded Care Manager

: The role of the professional case manager is changing rapidly. Health reform has called upon the industry to ensure that care is delivered in an efficient, effective, and high-quality and low cost manner. As a means to achieve this objective, health plans and health systems are moving the care manager out of a centralized location within their organizations to "embedding" them into physician offices. This move enables the care manager to work alongside the primary care physicians and their high-risk patients. This article discusses the framework for designing and implementing an embedded care manager role into a physician practice. Key elements of the program are discussed. IMPLICATIONS FOR CARE MANAGEMENT:: Historically care management has played a foundational role in improving the quality of care for individuals and populations via the efficient and effective use of resources. Now with the goals of health care reform, a successful transition from a volume-based to value-based reimbursement system requires primary care physicians to welcome care managers into their practices to improve patient care, quality, and costs through care coordination across health care settings and populations. : As patient-centered medical homes and integrated delivery systems formulate their plans for population health management, their efforts have included embedding a care manager in the primary practice setting. Having care managers embedded at the physician offices increases their ability to collaborate with the physician and their staff in the implementation and monitoring care plans for their patients. : Implementing an embedded care manager into an existing physician's practice requires the following:Although the embedded care manager is a highly evolving role, physician groups are beginning to realize the benefits from their care management collaborations. Examples cited include improved outreach and coordination, patient adherence to care plans, and improved quality of life.

COLLABORATE©

The purpose of this first of a three-article series is to provide context and justification for a new paradigm of case management built upon a value-driven foundation that Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is there will be constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby or Pokey. This is exactly why the definition of a competency-based case management model's time has come, one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than by the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. While there is inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

Case Management Provider Profile

Address correspondence to Joan Park, MHSc, RN, President. National Case Management Network, 229 Yonge Street, 3rd Floor, Toronto, ON, M5B 1N9 Canada ([email protected]) Professional Case Management is the official journal of the National Case Management Network of Canada. The author reports no conflicts of interest. The National Case Management Network is a federally incorporated nonprofit membership-based association dedicated to the advancement of excellence and professionalism among case management providers in Canada.

Case Management and Care Coordination: Best-Practice Workplace Solutions

As employers seek to mitigate the impact of the cost and duration workers’ compensation cases, companies are increasingly using integrated solutions to improve employee health and productivity. A key component is early intervention by a skilled clinical professional - a professional case manager. Case managers, particularly those who are board certified, have the requisite knowledge, skills, and expertise to act in a care coordination role to ensure access to the right care and treatment at the optimal time, in pursuit of desired outcomes - especially a successful return to work. Case managers also take a holistic approach that looks at the entire person, with communication and collaboration skills that builds consensus among stakeholders and increases buy-in by the injured employee. Through professional case management services, win/win solutions are pursued to meet the needs of the employee and the employer.

Case Management

Address correspondence to Joan Park, MHSc, RN, President, National Case Management Network, 229 Yonge St., 3rd Floor, Toronto, ON, M5B 1N9 Canada ([email protected]). Professional Case Management is the official journal of the National Case Management Network of Canada. The author reports no conflicts of interest. The National Case Management Network is a federally incorporated nonprofit membership-based association dedicated to the advancement of excellence and professionalism among case management providers in Canada.

NCMN Hopes to Partner With Veterans Affairs Canada

Address correspondence to Joan Park, MHSc, RN, President, National Case Management Network, 229 Yonge Street, 3rd Floor, Toronto, ON, M5B 1N9 Canada ([email protected]). Professional Case Management is the official journal of the National Case Management Network of Canada. The author reports no conflicts of interest. The National Case Management Network is a federally incorporated nonprofit membership-based association dedicated to the advancement of excellence and professionalism among case management providers in Canada.

Government of Canada Announces Funding to Support Case Managers in the Health Care Sector

Address correspondence to Joan Park, MHSc, RN, President. National Case Management Network, 229 Yonge Street, 3rd Floor, Toronto, ON M5B 1N9 Canada ([email protected]) Professional Case Management is the official journal of the National Case Management Network of Canada. The author reports no conflicts of interest. The National Case Management Network is a federally incorporated nonprofit membership-based association dedicated to the advancement of excellence and professionalism among case management providers in Canada.

Case Management Programs for Hospital Readmission Prevention

Professional Case Management: September/October 2012 - Volume 17 - Issue 5 - p 227-228 doi: 10.1097/NCM.0b013e3182661a4c

Fight or Flight? Resolving Conflict in the Professional Workplace

Address correspondence to Joan Park, MHSc, RN, President. National Case Management Network, 229 Yonge Street, 3rd Floor, Toronto, ON M5B 1N9 Canada ([email protected]) Professional Case Management is the official journal of the National Case Management Network of Canada. The author reports no conflicts of interest. The National Case Management Network is a federally incorporated nonprofit membership-based association dedicated to the advancement of excellence and professionalism among case management providers in Canada.

Motivational Interviewing

As professional case managers seek to improve outcomes, including the health status of their clients, it becomes imperative to gather and assess as much relevant information as possible to identify and address the client's needs in a holistic manner. Motivational interviewing is a highly effective technique case managers employ for this purpose. They also rely on it to move their clients toward a course of successful, desirable, and sustainable change, such as healthier diet, exercise, self-care, and adherence to medications regime and follow-up care. Across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, and other settings in which case managers work with clients and their support systems. Motivational interviewing is a highly effective technique for gathering accurate and comprehensive information that is supportive of and additive to the assessment phase of the case management process. Using motivational interviewing, case managers can more readily uncover health and lifestyle needs of their clients. This results in building trusting relationships and developing rapport with clients, which can motivate them to move toward successful and desirable change. The design and implementation of a comprehensive and effective case management plan of care is facilitated by motivational interviewing, whereby professional case managers establish collaborative, respectful, trusting and individualized relationships with clients. Using the specific principles and techniques of motivational interviewing, case managers take a holistic approach to care to address a client's willingness and ability to change; addressing self-confidence and other emotional triggers that affect change and support the client's ability to embrace and sustain positive change.

Wake Me Up for the Tsunami

Victoria Hadden is Project Manager, Communications for the National Case Management Network of Canada. Address correspondence to Joan Park, MHSc, RN, President. National Case Management Network, 229 Yonge Street, 3rd Floor, Toronto, ON M5B 1N9, Canada ([email protected]). Professional Case Management is the official journal of the National Case Management Network of Canada. The author reports no conflicts of interest.

The 6 Dimensions of Promising Practice for Case Managed Supports to End Homelessness

Professional Case Management: January/February 2012 - Volume 17 - Issue 1 - p 13-14 doi: 10.1097/NCM.0b013e31823f0ec3

Enhancing the Team Approach to Care With Professional Case Management

Dorothy Consonery-Fairnot, MSHA, RN, CCM, CLNC, is Chair of the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that certifies case managers (www.ccmcertification.org). She is also the founder and President of Fairnot & Associates Health Care Consulting, LLC. Address correspondence to Dorothy Consonery-Fairnot, MSHA, RN, CCM, CLNC, Commission for Case Manager Certification, 15000 Commerce Parkway, Suite C, Mt. Laurel, NJ 08054 ([email protected]). The author reports no conflicts of interest.

Educating Ourselves in the Changing Landscape of Case Management

Patrice Sminkey, RN, is the Chief Staff Executive of the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that has board-certified more than 30,000 professional case managers (www.CCMcertification.org). Address correspondence to Patrice Sminkey, RN, 15000 Commerce Parkway, Suite C, Mount Laurel, NJ 08054 ([email protected]) The author discloses that CCMC owns and operates CMBOK.

Case Managers Take “Whole Person” Approach to Workers' Compensation Cases

Margot Adam Langstaff, RN, BSN, MBA, is a Commissioner for the Commission for Case Manager Certification (CCMC), a nationally accredited organization that has board-certified more than 30,000 professional case managers. Ms. Langstaff received a BSN from the University of Connecticut and is an MBA graduate of Harvard Business School. Over the course of her 35-year career in health care, she has been involved in multiple areas including the military health care system, as clinical manager of Yale New Haven Hospital's Surgical Trauma Unit, and managing and staffing the first modern operating room/outpatient clinic in Haiti. She is the founder of LifeHealth (www.LifeHealthcorp.com), a wellness company based in Littleton, Colo. Address correspondence to 5554 South Prince Street, Suite 200, Littleton, CO 80120 ([email protected]) The author reports no conflicts of interest.