Treatment Pros And Cons Of Case Management In Health Care

Good Essays
Case management is a discipline that first evolved in health care. As medicine started to get more organized and accountable, hospitals needed professionals who could play many roles and also act as a liaison between patients and the health care workers. Case management has been defined as “a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes.” (Thinking Matters, 2009).
In general, case managers in hospital settings ensure that all patients are efficiently transitioned for appropriate care. More important, a case manager will ensure that there is an effective plan of treatment
…show more content…
It is rare for people to have any type of autonomy in healthcare, but case managers are one group of professionals that are only answerable to administration. The autonomy is by no means given, but only offered to people who excel in their work. Case managers oversee many types of work in a healthcare institution and have to know their limits. Their work is respected and thus, they often make independent decisions without having to consult with others.
Continued knowledge: Being a case manager means being continually on top of the job. This means being aware of the latest changes in healthcare and how they impact the healthcare institution. For example, with the introduction of ICD10, the case manager has to ensure that all billers and coders no longer use the old ICD 7. Otherwise, Medicare will not reimburse for healthcare services. Case managers have to keep up with all the HIPPA rules, OHSA requirements and the Joint commission regulations. In order to maintain the knowledge, case managers are always on the go attending seminars and webinars to keep up with the latest healthcare
…show more content…
This can create animosity, bitterness, and disagreement. Of course, no doctor wants to be told by a nurse case manager about medical charting or billing. Sometimes the case manager has to correct billers and coder and again this can lead to disharmony in the work place. While people may disagree, being a case manager is associated with a lot of resentment from other healthcare professionals because of the constant criticism and corrections.
Work overload: Being a case manager is not an easy job. It involves paying attention to minute details- mistakes can result in loss of finances to the hospital or poor quality care to patients. Besides, just reading medical charts, the case manager has to oversee mistakes, complications and patient safety. Case managers have to put in long hours at work because there is endless

Related Documents

  • Decent Essays

    Nursing Shortage is a problem we all should be aware of. There are many factors that may lead to a nursing shortage, such as having stressful and unsafe working environments, and our nurses are being overworked. This is a problem we should be aware of because it is affecting the patient care. Nurses, would not have enough time to stay with a patient if they have more patients to worry about. Nurses play a big role in our hospitals and communities.…

    • 1815 Words
    • 8 Pages
    Decent Essays
  • Decent Essays

    Physicians who understand how to implement the new detailed practices and help patients manage their illness more efficiently, can help push the changeover more quickly. Furthermore, the physicians and nurses need to have an ability to proficiently help patients manage their own illness; which includes proper medication usage, and help patients navigate throughout the health care system. It is also crucial that all the health professionals recognize the importance of delivering care in a uniform fashion. Additionally, health care professionals need to be committed to following the specific guidelines in order to deliver consistent care to a large number of patients efficiently. There are new rules, new standards, new technologies, and new solutions to merge into the daily operations of a health care delivery system (Page, 2001).…

    • 976 Words
    • 4 Pages
    Decent Essays
  • Decent Essays

    The employees define the quality by the level of care that they can provide. The nurses can affect the organization needs to improve quality for maximum patient satisfaction. The clinicians want the correct diagnosis, find better treatments for patients. The payers consider the finances as they identify if treatments and the volume of care and costs to the company (Hughes, 2008). The doctors in hospitals must report directly any quality issues, or any error could happen to their supervisor.…

    • 873 Words
    • 4 Pages
    Decent Essays
  • Decent Essays

    Clinical decisions are used daily by healthcare service providers for daily routine task. They are often based on clinical guidance and evidence-based rules derived from medical science. A clinical decision support system (CDSS) “is an application that analyzes data to help healthcare providers make clinical decisions. A CDSS is an adaptation of the decision support system commonly used to support business management.” (5) It is described as a process that helps healthcare providers make health related decisions and actions that are important and relevant to the providing the patient with improved healthcare service. Clinical Decision Support systems are expected to be one of the most necessary operations for healthcare systems to improve the quality cost of delivering healthcare.…

    • 2277 Words
    • 10 Pages
    Decent Essays
  • Decent Essays

    The medical attendant should give and advocate for support, nutrition, security and any future arrangements. A geriatrician is basic in the entire procedure. Other associated health experts including the social workers, speech therapists, occupational therapists, clinical psychologist, physiotherapists amid other health experts. The expanded rate and pervasiveness of Alzheimer's, in this manner, has loading ramifications of the medical sector. This is because of additional time, labor and different assets required in the administration…

    • 1811 Words
    • 8 Pages
    Decent Essays
  • Decent Essays

    However, doctors are the ones that focus on patients’ symptoms, not what is in their pockets. It is true that inside an office, doctors care for patients, yet the time to get there can be tedious. Since healthcare is an expensive system, doctors can be picky at which insurance to accept. This can prolong the illness and discourage patients from seeking treatment. Growing up I have personally experienced such dilemma.…

    • 977 Words
    • 4 Pages
    Decent Essays
  • Decent Essays

    This help the governing board of a hospital to confer on the medical staff the power to set up a form of organization by which that staff can give assurance of quality hospital medical care (Taylor, nd). This assignment is helpful for me because it helps me to understand the formation process of hospital staff, their duties, requirement and the rules and regulation they need to follow while providing…

    • 896 Words
    • 4 Pages
    Decent Essays
  • Decent Essays

    “JAAPA’s mission is to support the ongoing education and advancement of Pas by publishing current information and research”4. Original research and brief reports are certain types of journals published others may be case reports and reviews. According to Erin Metcalf, she uses JAAPA constantly and uses the information learned from the journals to help aid patients daily. Keeping up to date in the medical field is extremely important in order for citizens to receive the best medical aid possible. Conclusion Physician assistants have a lot of work on their plate throughout the work day.…

    • 1031 Words
    • 4 Pages
    Decent Essays
  • Decent Essays

    Describe a specific organizational situation where silence would be the unethical choice. Or, describe a situation where communicating would be the unethical choice. Explain why you believe doing so would be unethical. A specific organizational situation where silence can be considered unethical choice will involve the chronic shortage of staffing in a healthcare setting. In today’s healthcare environment, shortage or understaffed clinicians in the workplace is rampant, this can be partly credited to the growing number of the geriatric population, and the chronic shortage of qualified healthcare professionals.…

    • 461 Words
    • 2 Pages
    Decent Essays
  • Decent Essays

    There have to be many IT staff on alert to make sure all information is secured properly. In any healthcare system everything about taking risks, and changes are always made throughout healthcare, so it is very important to make sure there are no distractions to make sure patient care is the top…

    • 716 Words
    • 3 Pages
    Decent Essays