Case management is not a profession unto itself but a practice that encompasses many disciplines. Nursing is the predominant field of the practice of case management, while social workers and other healthcare professionals combine to make up a mix of dynamic professionals with a central goal—to focus the system and facilitate the delivery of care. The discipline of nursing focuses on the whole person, which is a key case management concept.
It is important to remember that no single discipline owns the practice of case management. Therefore, it is essential that each individual involved in the practice follow his or her governing state’s Practice Act as dictated by his or her respective…
More specifically, who coordinates the proliferating number of health care helpers variously known as case managers, care managers, care coordinators, patient navigators or facilitators, health coaches or even — here’s a new one — “pathfinders”?
Case managers have a lot of responsibilities—from facilitating educational coping skills groups and having in-depth conversations, to doing fun and engaging activities with clients. Primarily, however, my job involves helping others feel better, feel validated, and rebuild their trust in humanity when others have broken that trust
As medical care becomes more fragmented and complex, people are turning to professional care managers who help with filing insurance claims, finding the right doctors or managing the care of an elderly relative who lives far away.
It has been widely observed that a good case management process can reduce length of stay, diminish prescription errors, eliminate needless tests and unnecessary resource use, and lower readmission rates.
Case managers are uniquely positioned to make that strong connection between helping individuals navigate [insurance choices], as well as assisting them in understanding whatever circumstance or condition brought them to need those services in the first place.
As case managers, we do research every day whether it is looking at readmissions, effectiveness of patient teaching and many other processes. We use the scientific process: assessment, analysis, goals, intervention, analyze and evaluation when dealing with issues
Hospital EDs must continually make an expensive decision: whether to admit a patient, and to which level of care. ED Case Managers play a key role in this decision, helping to ensure appropriate admissions while reducing per-patient costs and resolving resource and service gaps.
Out of the vast number of specialties in the nursing field there is one that stands out from the crowd. It requires a broad reach beyond just patient care in a hospital. This registered nurse treats patients, but the care extends to loved ones and caretakers of the patient as well as financial institutions. This specialized health care professional is the nurse case manager.
Case managers become subject matter experts, translators, navigators, confidants, and aides to a vast population with a varied knowledge of healthcare.
Nurse case managers are the ultimate project managers. Like a complex project, they view an injured worker from all angles – then they fill gaps, connect pieces and ensure everyone is talking. The end result – shorter claims, lower medical costs and a happier, healthier worker.
Nurses enter the medical field determined to make a difference in people’s lives, yet how they do it depends on their own unique knowledge, strengths, and personality. Just like a pair of scrubs, there is no single nursing role that fits everybody. Some people thrive in the frenzy of an ICU. Others need a different vantage point to affect abiding changes such as education or management.
A relationship with a professional geriatric care manager can allow the children of the elderly person to be children, while someone else manages the situation.
Case management is not a new concept. It traces its history back to the early 1900s, when it
simply functioned as a means of providing care and containing healthcare costs. In the 1920s,
the practice found its roots in the fields of psychiatry and social work, and focused on longterm chronic illnesses that were managed within the community.
A Human Services Blog by Martin Gardner.
CMSA is the leading membership association advocating for patients’ wellbeing and improved health outcomes by fostering case management growth and development.
Since our founding in 1986, The Center for Case Management has been the industry leader in the custom-development of tools, roles, and systems for managing outcome-driven care.