Role Of Case Manager Research Articles

A Literature Review on the Benefits for an Interprofessional Educational Program to Increase Novice Nurse Awareness of Case Management in Heart Failure.

The purpose of this literature review is to examine the potential value for an interprofessional education program to increase novice nurse awareness of case management in heart failure (HF). Acute care health care settings involving novice nurses. Evidence demonstrates that interprofessional collaboration on transitional care interventions for HF patients reduces 30-day readmissions. Implementation of an interprofessional education program for novice nurses can be an effective intervention to decrease readmissions by increasing knowledge of the nurse case manager role and development of interprofessional relationships. Increased awareness of HF case management is important for novice nurses. Understanding the nurse case manager role and early interprofessional collaboration can improve patient health outcomes among the HF population. Therefore, an education program to build confidence and strengthen interprofessional partnership in HF case management for the novice nurse is warranted.

The roles of case managers and problems encountered in implementing patient centered care in hospitals

Background and purpose: Patient centered care in hospitals has yet to be well implemented. The role of case managers is very important in the implementation of patient centered care in hospitals. Research publications on the role of case managers in patient centered care in Indonesia remain limited. This study aims to explore the roles of case managers and problems encountered in the implementation of patient centered care in hospitals.Methods: This study used a qualitative design with a case study approach conducted at Bangli District Hospital in Bali in April 2019. Data was collected through in-depth interviews with seventeen purposively selected informants consisting of ten case managers, one deputy director of medical services, two patient's family members, two specialist doctors and two implementing nurses at Bangli District Hospital. This study uses the Patient Centered Care Framework from Greene which consists of three dimensions in patient centered care namely interpersonal, clinical and structural dimensions. Data was analyzed thematically using deductive and inductive techniques. Data validation was conducted through triangulation of data based on different sources, member checking and peer debriefing.Results: In this study, five main themes were found regarding the role of case managers in the implementation of patient centered care in hospitals, namely interpersonal, clinical and structural dimensions, support and expectations of case managers. The identified role of the case manager in the interpersonal dimension consisted of listening to patients and families actively, coordination and collaboration in problem solving, providing accurate and easy to understand information about care. Problems encountered included lack of communication between the service provider components and between the service provider with patients and their families. Roles of case manager in the clinical dimension are to hold meetings with a professional team of care givers and continuous monitoring of services to patients, while the issue encountered is the mismatch of time of service provision by specialist doctors. Roles of case managers in the structural dimension is coordination with policy holders, use of information technology and patient reporting. Problems encountered were inappropriate recruitment of case managers, lack of training of case managers, incomplete facilities, inconvenience of services and inadequate incentives. Supports from hospitals for case managers were support of facilities and legality as case managers. Expectations of case managers include case manager training, rewarding, and career development opportunities.Conclusion: The roles of case managers in implementing patient centered care in Bangli District Hospital are not optimal. Efforts to address issues in the interpersonal, clinical and structural dimensions need to be carried out by the hospital management to enhance the role of case managers in the implementation of patient centered care.

Smartphone Apps to Support Coordinated Specialty Care for Prodromal and Early Course Schizophrenia Disorders: Systematic Review.

BackgroundDemand for mental health services, especially for clinical high-risk and early psychosis, has increased, creating a need for new solutions to increase access to and quality of care. Smartphones and mobile technology are potential tools to support coordinated specialty care for early psychosis, given their potential to augment the six core roles of care: case management and team leadership, recovery-oriented psychotherapy, medication management, support for employment and education, coordination with primary care services, and family education and support. However, the services smartphones are actually offering specifically for coordinated specialty care and the level of evidence are unknown.ObjectiveThis study aimed to review the published literature on smartphone technology to enhance care for patients with prodromal and early course psychosis and schizophrenia and to analyze studies by type, aligned with coordinated specialty care domains.MethodsA systematic literature search was conducted on August 16 and 17, 2019, using the PubMed, EMBASE, Web of Sciences, and PsycINFO electronic databases. The eligible studies were reviewed and screened based on inclusion and exclusion criteria.ResultsThe search uncovered 388 unique results, of which 32 articles met the initial inclusion criteria; 21 eligible studies on 16 unique app platforms were identified. Feasibility studies showed a high user engagement and interest among patients, monitoring studies demonstrated a correlation between app assessments and clinical outcomes, and intervention studies indicated that these apps have the potential to advance care. Eighteen studies reported on app use for the case management roles of coordinated specialty care. No app studies focused on employment and education, coordination with primary care services, and family education and support.ConclusionsAlthough the published literature on smartphone apps for prodromal and first-episode psychosis is small, it is growing exponentially and holds promise to augment both monitoring and interventions. Although the research results and protocols for app studies are not well aligned with all coordinated specialty care roles today, high rates of adoption and feasibility suggest the potential for future efforts. These results will be used to develop coordinated specialty care–specific app evaluation scales and toolkits.

Put an End to Missed Opportunities.

The ongoing transformation of America's health care system is bringing disruption in every sector of our industry. Hospital case management programs are similarly undergoing dramatic changes as care coordination for our most vulnerable patients becomes the focus of many hospital case management programs. As a result, case management leaders and human resource directors are disrupting legacy assumptions and expanding eligibility for the role of the hospital case manager.

Case management: An overview for nurses.

Case management offers an exciting opportunity for nurses as they decide how best to serve their patients. This article discusses the role of case managers in the healthcare setting.

Dementia in Canadian primary health care: The potential role of case management

Dementia in Canadian primary health care: The potential role of case management

Transition From Hospital to Home: The Role of the Nurse Case Manager in Promoting Medication Adherence in the Medicare Population.

Lack of adherence to medication plans is a factor in costly hospital readmissions. Adherence to medication plans in the home care setting in relation to hospital readmission is a major issue among the Medicare population. Nurse case managers are in a key position to provide care after hospital discharge to promote medication adherence and thus reduce the chance of hospital readmission. This article discusses barriers to taking medications as prescribed and directed, the importance of ongoing medication reconciliation at home, and strategies to promote adherence to medication plans.

Optimizing Licensed Practical Nurses in Home Care: Their Role, Scope and Opportunities.

This research examined the role and scope of licensed practical nurses (LPNs) in home care (HC) and case management. Case management is relatively new to LPNs in Alberta having been added to their list of competencies in 2015. The extent to which LPNs are performing functions and the circumstances or criteria that shape their reported case management functions and role are not clear. Our research questions were: a) What roles do LPNs play within HC and case management? and b) What roles could LPNs play within HC and case management given their scope of practice to achieve optimal client outcomes and system efficiencies? We used a mixed methods multiple case study design to engage LPNs in case management practice, their managers and HC leaders from rural, urban and suburban HC offices. Approaches for data collection included semi-structured interviews, participant observation, focus groups, document review and survey.

Laying new foundations for 21st century community mental health services: An Australian perspective.

While there has been a significant increase in investment in community mental health in Australia since the advent of the National Mental Health Strategy in the early 1990s, there has been little guidance on service design and delivery. This has led to a growing diversity of approaches and concern about the adequacy of care with repeated calls for a system overhaul. Consumers and carers have very largely been absent from decision-making about service design and development which has led to a system primarily designed by healthcare professionals. However, with the emergence of recovery as a core principle in mental health, it is time for consumers and carers to be centrally engaged in co-designing services with service providers. This raises the question of whether dominant service delivery models - such as the growth of specialist teams/services, the changing balance between profession-specific and generic case management roles in multidisciplinary teams, and the separation of inpatient from community care - will prevail. Contentious issues in these three service delivery areas are outlined to stimulate debate and highlight the pressing need for national guidance on the configuration of community mental health services. Building on the lessons learned from the first National Mental Health Strategy, we outline a proposal for a co-designed National Framework for Community Mental Health Services to guide the delivery of care in a way which satisfies the aspirations of consumers, carers, and mental health professionals alike.

Coordinating objects of care: Exploring the role of case managers as brokers in cancer patient pathways.

Healthcare systems increasingly make use of case managers to handle organisational complexity. In Danish cancer patient pathways, case managers handle the complexities of cancer diagnostics and treatment while adhering to pathway guidelines. This article explores how case managers handle their various responsibilities and focuses on the micro-politics of case management. An ethnographic study was carried out in three Danish cancer patient pathways. Interactions between patients and healthcare professionals were observed, including professionals with case management tasks. We interviewed 13 cancer diagnostic patients in their homes and 26 healthcare professionals during work hours, among other things about case management. We found that the work of case managers differs between cancer patient pathways and settings but overall emphasises coordination of patient trajectories and being contact person. We argue that case managers, embodying the figure of the broker, handle their responsibilities by coordinating the following co-existing objects of care, each with different goals: the diseased body, the person, the organisation and the cancer patient pathway. We conclude that case managers, in addition to being a response to the complexity of healthcare services, impact the implementation of cancer patient pathways and influence cancer diagnostic activities.

Utilization of Outpatient Social Work Services Among Veterans with Combat-Related Polytrauma: A Review and Case Analysis

We examined outpatient social work service utilization and associated costs among patients with combat-related polytrauma who received services at a veterans’ hospital in the southeast United States between 2007 and June 2011. This is a retrospective cohort study of a purposive sample of 265 service recipients using secondary data extracted from the Veterans Health Administration Medical SAS Outpatient and CPRS databases. Combat-related veterans (n = 265) with polytrauma had a total of 10,437 outpatient social work service encounters and received 91 different outpatient social work service procedures, providing a total number of 8,564 outpatient social work service procedures. The highest frequencies for procedural and diagnostic coding are “unspecified.” The provision of social work services needs to be studied to maximize efficiency, cost-effectiveness, and the quality of care being provided to veterans with combat-related polytrauma. Research studying the role of social work case management in the continuum of care is limited and warranted expansion.

Implementation of Roles and Functions of Case Managers

Case management is an intervention strategy used by health care providers and systems to support clients, coordinate health services, and facilitate results in both price and quality. In this model of care, the case manager plays an important role in ensuring that the case management service flow is well implemented. This study aims to see how the role of case managers in carrying out their functions such as utility assessment, planning, facilitation and advocacy, service coordination, evaluation, and post-discharge follow-up. The research method used is the mixed method sequential exploratory design. This method explores the work experience of a case manager in the field, then composes a measuring instrument, and then seeks to quantify the role and function of the case manager. The population in this study was the case managers in the Kemuning and Fresia Building at Dr. Hasan Sadikin General Hospital Bandung amounting to 36 people. The research sample was divided into two, in the qualitative stage the number of participants as many as 5 people was determined by purposive sampling technique, and the quantitative stage used a total sampling of 36 people. The results showed that the qualitative analysis of the assessment function identified indicators of ability to collect data, analysis, and stratification of patients; in the planning function the ability to determine goals, take joint decisions and identify problems were identified; in the facilitation function and advocacy, the ability to be identified as an educator, protector of patient rights and solution provider were identified; in the service coordination function, the ability for team communication and communication between lines were identified; in the evaluation function the ability to evaluate patients and self-evaluation were identified; and in the post-discharge follow-up function the ability related to continuity of service was identified. In the implementation, the case manager carries out those functions, 4 functions are still carried out improperly by most respondents such as the joint decision making, team communication, patient evaluation, and self-evaluation.

Experiences of case managers in providing person-centered and integrated care based on the Chronic Care Model: A qualitative study on embrace

BackgroundDue to the rise in the number of older adults within the population, healthcare demands are changing drastically, all while healthcare expenditure continues to grow. Person-centered and integrated-care models are used to support the redesigning the provision of care and support. Little is known, however, about how redesigning healthcare delivery affects the professionals involved.ObjectivesTo explore how district nurses and social workers experience their new professional roles as case managers within Embrace, a person-centered and integrated-care service for community-living older adults.MethodsWe performed a qualitative study consisting of in-depth interviews with case managers (district nurses, n = 6; social workers, n = 5), using a topic-based interview guide. Audiotaped interviews were transcribed verbatim and analyzed using qualitative content analysis.ResultsThe experiences of the case managers involved four major themes: 1) the changing relationship with older adults, 2) establishing the case-manager role, 3) the case manager’s toolkit, and 4) the benefits of case management. Within these four themes, subthemes addressed the shift to a person-centered approach, building a relationship of trust, the process of case management, knowledge and experience, competencies of and requirements for case managers, and the differences in professional background.DiscussionWe found that this major change in role was experienced as a learning process, one that provided opportunities for personal and professional growth. Case managers felt that they were able to make a difference, and found their new roles satisfying and challenging, although stressful at times. Ongoing training and support were found to be a prerequisite in helping to shift the focus towards person-centered and integrated care.

National Case Management Week 2018.

National Case Management Week 2018.

Providing physical health care for people accessing mental health services: Clinicians' perceptions of their role.

The prevalence of health risk behaviours and associated poor physical health is high in people with severe mental illness. Mental health service guidelines and policies stipulate that mental health services should address physical health of people who access services. This study reports results from a large, interdisciplinary, cross-sectional study exploring mental health clinicians' (n=385) views of role legitimacy in physical health service provision. All disciplines reported that mental health clinicians have a role to play in addressing the physical health of consumers. Among mental health clinicians, psychiatrists and mental health nurses received higher endorsement than allied health clinicians in relation to the provision of physical health care, with primary care providers including general practitioners also ranking highly. As community mental health services routinely appoint allied health staff to case management roles, a challenge for services and a challenge for clinicians are to ensure that physical health and the effects of medication are monitored appropriately and systematically. Online and telephone support services received relatively lower endorsement. As the availability of nonface to face services increases, there is a need to explore their utility in this population and where appropriate promote their uptake.

Physical Health in Public Mental Health Care: A Qualitative Study Employing the COM‐B Model of Behaviour to Describe Views and Practices of Australian Psychologists

ObjectiveTo inform improvement in the process and outcomes of care by describing the views and practices of psychologists working in public mental health services (PMHS) regarding provision of physical healthcare for consumers.MethodCross‐sectional qualitative study employing a theoretical model of behaviour (capability, opportunity, motivation, and behaviour; COM‐B model). Data collected in semi‐structured interviews with maximum diversity sample of 29 psychologists were analysed using the framework approach.ResultsParticipants were cognisant of the need to improve physical health among people with severe mental illness (SMI); they endorsed, to varying extents, the obligation of PMHS and potential of psychologists, collectively to contribute to this goal through provision of interventions targeting health behaviours. Within a context in which psychology was generally underutilised, practice varied widely, ranging from avoidance to integration of physical health care in clinical practice. In combination, mixed‐messages about service priorities, role ambiguity, competing demands, and concern about adequacy of knowledge and skills inhibited attention to physical health for most participants, particularly those working in generic case management roles. Some highly motivated psychologists, most of whom worked in specialised teams within which attention to physical health was normative, made and capitalised on opportunities to develop and apply skills to enable consumers to change behaviour and improve physical health.ConclusionWhile further education and training will enhance capability and motivation of psychologists, realisation of the potential contribution to improvement in physical health of people with SMI will fundamentally, require assertion of the identity and value of the profession within mental health services. Ensuring optimal use of scarce resources necessitates careful consideration of deployment of discipline specific expertise, and clarity about responsibilities of psychologists within teams.

DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES.

Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery.Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of "frugal innovation" to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad.

Hypertension management: what is the role of case management?

Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension - joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.

A STARR is Born! A shining example of Integrated Care

In 2016, Queensland Health funded an innovative pilot for integrated care in a regional mental health service to improve consumer outcomes.(i) The STARR service model has funding for one year to determine the viability, applicability, and sustainability of integrated social and mental health services. Building on the international, national, and state strategies for integration, a service contract that required colocation, collaboration, agreed intent; and processes to coordinate services, was developed and implemented.(i) This abstract addresses integrated care between a regional Adult Mental Health Team and a Non-government organisation (NGO). The region provides case management and support to clients aged 18 or over, who have a severe and persistent mental illness; complex psychosocial needs, many requiring care co-ordination across sectors. Implementing collaborative, integrated shared care models is a challenge.(ii) Undertaking this in a regional setting presents the potential for sustainable and replicable service delivery frameworks. The Support Time and Rehabilitation Recovery Service (STARR), provided by a contracted NGO working with clinicians, aims to deliver better coordination of psychosocial supports to clients and their families. In devolving care coordination to the NGO, the intent of this pilot was to demonstrate increased capacity for clinicians to deliver therapeutic interventions to improve an individual’s health.(iii,iv) The first quadrimester has shown 15 referrals to STARR on the first day; with a total 79 referrals for this period with over 1260 hours of psychosocial supports delivered to mental health consumers.. Early indicators attest clinicians have decreased the time spent coordinating services, increased dedicated time for individual care by 5%, and increased therapeutic interventions by 2%. Collaboration has driven a range of holistic approaches in its first quarter with jointly developed care plans, case reviews, and targeted programs, including smoking cessation, a social recovery and carer program. Referrals to STARR have become routine practice for clinicians and the NGO has become an integrated part of the team. Co-location has been critical, in the early uptake of the service. Shared communication has been integral to develop shared intent. Engagement of clinicians, clients, and carers has been imperative and involvement from both organisations has reinforced shared intent. The early success of this pilot commenced with stakeholders documenting the service model inclusive of reorienting the role of case managers. Integration of an NGO into the clinical setting has increased consumer access to psychosocial and rehabilitation support services. STARR demonstrates that the challenges to implement an integrated model can be addressed.(iii,iv) The (STARR) Service, provides an innovative example of a NGO working in partnership with a public Mental Health Service delivering the key elements of integrated care, collaboration, coordination, and co-location. A STARR is born.(v)

WHO SHOULD BE THE CASE MANAGER FOR PERSONS WITH MENTAL ILLNESS? SOCIAL WORKER, NURSE OR OCCUPATIONAL THERAPIST?

Case manager for persons with mental illness is a skilled professional who works directly with clients and administers specialized care to them. The ultimate goal is to facilitate clients to re-integrate into the community during their recovery process. In Hong Kong, professionals usually employed as case manager in the community setting are social workers, psychiatric nurses and occupational therapists. In principle, every member of the recovery team could be the case manager. However, who is the best fit for this role? This article discusses which professional would best fill the role of case manager. The role of case manager and their relationship with clients are examined. The article explores the core values, roles, functions and work practice of three disciplines in caring for the mentally ill. The code of ethics, training and characteristic of approaches employed from each discipline are reviewed and discussed. In conclusion, social workers, nurses and occupational therapists share similarities in philosophy and theoretical foundations. Expertise from each discipline complements one another and contributes to the symphony in the recovery journey.