The process of collaborating process that include assess, processes of planning and care coordination, processes of monitoring and evolution is what can be known as case management. These processes are crucial since they help in services that aim to cater for human needs, such services may include health, social services, education and employment. Well-Designed case management in an organization has several benefits including improving process manageability by allowing significant improvements on internal processes. Case management has the ability to allow for meaningful and organized information. Information is readily accessible if the information available is within a single case file. Case management will also allow for better decision making in the organization. Case management allows greater efficiency to be easily achieved. Various disciplines have practiced case management throughout history. Case management has over the years evolved and provided further roles and functions that are fulfilled by case managers, therefore case management has been able to provide and meet a client’s need (Flynn & Kilgallen, 1993).
The concept of case management has been in existence for over 90 years and just like how language evolves, case management has undergone evolution over the years. period the concept of case management began it focused on the fields of social work, the fields of psychiatry and focused on long term chronic illnesses. Visiting nurses used the processes of case management at that time in the 1930s. Between the years of 1930 and 1980 case management model remained in the community setting. It later changed to a new concept to the acute care setting after the introduction of the prospective payment system. Case management has undergone tremendous evolution because in the past case management was focused on utilization management. Utilization management majorly included to designate and identify the appropriate patient status and the level of care that patients received. Utilization management also consisted of managing denials and appeals and the escalation process (Dos Santos, Powell, & Sarshar, 2002).
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Case management also included discharging and planning by identifying those patients need for post-acute care and managing the placement process and the referral process. In the past case, management also included compliance whereby case management systems conditions of participation is met by the case management organization. Case management in today’s time is a clear proof of how case management has undergone serious evolution. In today’s case management, an addition of two new areas of focus has been identified in the concept. Two features that have been included in the case management concept include care coordination. This is because of increased pressure on the systems of health to manage patients across the system. This has seen the evolution of case management into a combination of traditional inpatient case management and ambulatory care coordination. The second feature that has seen case management evolve is patient education. This means that it is important for patients to receive post-acute care and the place where they get the care is consequential. It is now the role of a case manager to balance patient choice with the impact act and conditions of participating foe the patient (Dos Santos, Powell, & Sarshar, 2002).
The school of thoughts during each period consists of the classical school of thought, the behavioral school of thought, the quantitative school of thought and the contingency school of thought. In the early 19 th century classical school was established that included the management process school was the approach used in case management. The school of thought regarded the management as a process of getting things done with people in a team or group. The founder of the school was Henry Fayol. According to him, management is better understood in terms of the processes that are involved; in this case, the processes that were involved understood case management better. The significant issues that that existed during those times were organizing and understanding the functions and roles of management. The school of thought was later criticized to be rigid and inflexible. Later a Behavioral school was established. The behavioral school consisted of human relations and behavioral science. The school emphasized the psychological factors that caused a change in human behavior in a team or group in certain situations. It also focused on the fact that management must center on people and their interpersonal relations. The significant issues that existed during those times were effective leadership and motivation. Thereafter, the quantitative school that focused on improving the decision-making process by applying quantitative techniques was formulated. A school of thought the significant issues that existed at this time was the problem that managers experienced while making decisions. The contingency school of thought was then established, and it emphasized on an action-packed discipline and that management is a highly practice-oriented discipline. The school of thought dictated that there is not one way to execute managerial duties and that it depends on various situational factors like technology and other external environmental factors (Ofori-Dankwa & Julian, 2005).
The roles and functions of case management have changed. The main reason behind the changing roles and functions of case managers can be attributed to the features of the case management and how it has evolved over time as discussed in the second paragraph. During the early times, the functions and roles of case management were centered on inpatient functions. The functions of case managers included performing administrative tasks in the office; they also were used to manage denials, appeals and escalation processes. The other function included ensuring compliance and maintaining case files or patients that are completing treatment plans. Generally, the roles and functions focused mainly on compliance, discharge planning, and utilization management. In the late 19 th century as case management evolved and additional features were added into the concept, the roles and functions of case managers also changed. They mainly focused on care coordination. Care coordination avoids the fragmentation of care and the patient is able to identify whether his needs have been met. The role of case managers, therefore, is to develop plans that include all services that are received by patients. The roles and functions of case managers were also centered on patient education. Case managers were responsible to ensure that patients received post-acute care (Hussein, 2010).
The changing correctional approaches in case management have affected positively on its roles and functions. Since its beginning where case management began as a community-based model the roles and functions of case management were minimal and never focused on care coordination, patient, and post-acute care. The correctional changes ensured that the case management has been introduced into hospitals and now the functions of case management are a hybrid of a community base model and a hospital model. Correctional changes have enabled better decisions to be made in case management. Acute inpatient rehabilitation has been developed and insurance companies have been established to coordinate care and ensure appropriate care. The changing correctional approaches have had a positive impact on the roles and functions of case management because now case managers are able to manage patients across the continuum (Frankline, Solovitz, Mason, & Miller, 1987).
References
Dos Santos, A., Powell, J. A., & Sarshar, M. (2002). Evolution of management theory: the case of production management in construction. Management Decision , 40 (8), 788-796. doi:10.1108/00251740210437743
Flynn, A. M., & Kilgallen, M. E. (1993). Case management. Journal of Nursing Care Quality , 8 (1), 58-66. doi:10.1097/00001786-199310000-00008
Franklin, J. L., Solovitz, B., Mason, M., Clemons, J. R., & Miller, G. E. (1987). An evaluation of case management. American journal of public health , 77 (6), 674-8.
Hussein, T. (2010). Case Management Roles and Functions Across Various Settings and Professional Disciplines. Professional Case Management , 15 (5), 278-279. doi:10.1097/ncm.0b013e3181f5a71f
Ofori-Dankwa, J., & Julian, S. D. (2005). From Thought to Theory to School: The Role of Contextual Factors in the Evolution of Schools of Management Thought. Organization Studies , 26 (9), 1307-1329. doi:10.1177/0170840605054620
