Case management in healthcare involves processes that ensure appropriate treatment plans are followed and recommended medical care is adequately provided. Case management uses an integrated system that oversees the administration of quality healthcare services to patients (Snoddon, 2010). The main activities associated with case management in healthcare are cared for assessment and development and implementation of a treatment plan. After developing and implementing a medical care plan case managers analyze the results of the administered treatment. Case management involves holistic care which is a standard requirement in health sciences and therefore healthcare providers in other fields can transition with ease. Health care providers who want to operate independently in the American health care system are provided with a credential to prove his eligibility.
A professional case manager develops and implements a health care plan while involving health care providers, the patient and relatives in the process. Professional case managers deliver personalized services to patients by employing four steps:
Delegate your assignment to our experts and they will do the rest.
Referring patients to appropriate health care providers.
Developing and administering care.
Analyzing results of each patient and modifying the treatment plan.
Evaluating the effectiveness of the entire program.
Patient-centered care helps patients reach the best health levels while reducing healthcare costs. Case managers ensure that care is patient-centered by using program such as the Guided Care program which is implemented in the Johns Hopkins’ hospital. This program ensures that the efforts of healthcare providers in all settings are coordinated. The Geisinger Navigator model allows nurse case managers to be involved in the provision of healthcare process and gives them data and analytical capabilities (Gilfillan et al. 2010). The data is used to analyze each patient’s condition, therefore, developing a treatment plan for each patient.
Effective case management involves developing a treatment plan and including healthcare providers, the patient, and relatives in the process. Involving all stakeholders in the process eliminates any communication gap that may arise during the provision of healthcare. A professional case manager evokes the patient’s agenda by using open-end questions to understand them better. Patient-centered communication allows the case manager to understand the patient’s perspective of the illness, therefore, developing a unique treatment plan. Additionally, the case manager should seek the input of all health care providers that will be involved.
Case management has been shown to raise the levels of satisfaction among patients, quality of life and healthcare costs. According to Dean et al. (2014), case management improves patient satisfaction among patients suffering from cancer and congestive heart failure. However, case management does not reduce mortality rates among patients suffering from chronic diseases. Although the mortality rates cannot be lowered, case management improves the quality of life of patients. Case management improves satisfaction levels among the patient and health care providers and this can be attributed to improved coordination of activities. Although case management improves the quality of life and satisfaction of patients, it is associated with increased cost of healthcare. This increase can be linked to extra costs of planning.
Care coordination is a trend that is helping healthcare givers to combat challenges that come with the fact that millions of people who had no insurance can now access health care. As a case manager, care coordination helps me to manage healthcare complications such as complex cases. I would encourage other health care providers to employ care coordination to ensure that they offer quality services to patients.
References
Dean, A., Seehusen, M.D., & Meghan, R. (2014). Effectiveness of Outpatient Case Management for Adults. American Family Physician. 90(7): 481-483.
Gilfillan, R.J., Tomcavage, J., Rosenthal, M.B. (2010). Value and the medical home: effects of transformed primary care. Am J Manag Care .16(8):607-614. (http://www.ajmc.com/media/pdf/AJMC_10augGilfillan607to614.pdf).
Snoddon, J. (2010). Case Management of Long-term Conditions: Principles and Practice of Nurses. Malden, MA: John Wiley & Sons Ltd. Pp. 19-21. ISBN 9781405180054
