Case Management in Today’s Healthcare System
American healthcare is experiencing a paradigm shift in which the focus is no longer on acute care treatment but on prevention and management in the outpatient setting. Case management is a process that focuses on prevention, which ultimately results in better patient outcomes and ensures that the client is receiving cost effective quality healthcare. According to Smith, MacKay and McCulloch, “case management lacks a singular definition, but chiefly describes a package of care that covers a range of activities, rather than a single intervention” (2013, p. 452). In order to accomplish and, more specifically, manage these activities, case management must take charge and control the cases that are …show more content…
The case manager is identified as a “professional with nursing qualifications holding a caseload with responsibilities for overseeing and/or delivering the processes of case finding, assessment, care delivery, monitoring and review for, and with, a patient and their family” (Gage et al., 2012, p. 191). The case manager must use “case management techniques to support people with complex long, term conditions to reduce costly unplanned hospital admissions….they are the leaders in case management” (Gage et al., 2012, p. …show more content…
Technology has influenced today’s healthcare, for today’s managers must be proficient with face to face dialogue, in addition to communication via written documentation, fax, telephone and e-mail and video (Stanhope & Lancaster, 2014). It is not uncommon for case managers to make referrals to other specialists in order to achieve a higher level of care. These referrals often require a fax that includes a detailed description of the problem, past medical history, payment methods and goals of therapy. It is also helpful to communicate the specialist to confirm desired outcomes and to ensure that there are no ambiguities. Also, communication with the client is most imperative to verify that the client understands the purpose of the referral and can acknowledge the goals for the plan of
American healthcare is experiencing a paradigm shift in which the focus is no longer on acute care treatment but on prevention and management in the outpatient setting. Case management is a process that focuses on prevention, which ultimately results in better patient outcomes and ensures that the client is receiving cost effective quality healthcare. According to Smith, MacKay and McCulloch, “case management lacks a singular definition, but chiefly describes a package of care that covers a range of activities, rather than a single intervention” (2013, p. 452). In order to accomplish and, more specifically, manage these activities, case management must take charge and control the cases that are …show more content…
The case manager is identified as a “professional with nursing qualifications holding a caseload with responsibilities for overseeing and/or delivering the processes of case finding, assessment, care delivery, monitoring and review for, and with, a patient and their family” (Gage et al., 2012, p. 191). The case manager must use “case management techniques to support people with complex long, term conditions to reduce costly unplanned hospital admissions….they are the leaders in case management” (Gage et al., 2012, p. …show more content…
Technology has influenced today’s healthcare, for today’s managers must be proficient with face to face dialogue, in addition to communication via written documentation, fax, telephone and e-mail and video (Stanhope & Lancaster, 2014). It is not uncommon for case managers to make referrals to other specialists in order to achieve a higher level of care. These referrals often require a fax that includes a detailed description of the problem, past medical history, payment methods and goals of therapy. It is also helpful to communicate the specialist to confirm desired outcomes and to ensure that there are no ambiguities. Also, communication with the client is most imperative to verify that the client understands the purpose of the referral and can acknowledge the goals for the plan of