The definition of Case Management by a Public Health Nurse is
“to promote health education, prevention, control and/or minimization of disease and disability; through assessment, examination, diagnosis, evaluation, and care planning activities in a community.”
Case Management Addresses a Wide Variety of Patient Concerns and is Implemented for Multiple Reasons
Supporting patients in their illnesses, MD appointments and medication facilitation, non-compliance challenges, "System" Challenges, Health Education/Promotion, and access to agencies,
Health fairs, Immunization programs,
Full Spectrum of patient concerns and needs...
Day care and school promotions for health,
Home Assessments child safety & nutrition,
Maternal Child Health challenges,
Family Planning, and Disease Surveillance/Management.
Patient Satisfaction with Case Managed Case Systems is generally high. The services bridge/link the patient to all services to provide a sense of well being through primary care support and assistance with all patient directed concerns first
Food, shelter, child-care priorities are met first.
Individualized care, consistency and continuity trust building.
Good communication skills, needs assessment proficiency, cultural sensitivity.
The prevailing component of case management .
Moves the patient towards optimal care outcomes.
Identification of the goals of the patient and the outcomes desired by the assessment of care needs by the case manager allows, for a time table towards the achievement of the goals to be planned.
Removed through a care coordinated effort, with the case manager identified as the primary
resource contact and facilitator for the patient.
Facilitating and Promoting of patient Care Minimizes Fragmentation, and reduces agency duplication of services secondary to multiple and complicated social and healthcare problems.
Assuming primary gatekeeper role for other agency services related to achievement of outcomes
They provide a primary contact for the patient by defining the players and avoiding deviation from the goal of the intervention. They act as communication conduits for the patient focused on a review of ongoing ancillary needs, such as transportation, child-care, education etc.
Maximal Care Coordination of The Disciplines within the Health Care Team. They work intimately with all of the healthcare team members through updates and inquiry by:
"Alliance Building" to eliminate counter productive activities.
To block activities that waste or duplicate resources given to patient.
Promote cost-effective care and maximal care coordination of the disciplines within the Health Care Team.
Establishes a role as "patient’s partner" to associated players in the team towards moving the patient towards outcomes. Promotes the patients needs within the framework of the team and out when necessary. Roles clarified and repositioned based upon outcome need.
They navigate the system by patient "Hand Holding " so that the patient feels protected, respected and one of the decision makers. Case Management Responds to the Needs of Insurers and Other Third Party Payers Towards Cost Effective Care.
Promotion of patient participation by identification of barriers and opportunity. Maximize patient continuity of care. Facilitation and location of a "medical home" within the community. They provide home health and patient assessments for disease management.
Case Management: A Merger of Clinical, Financial Systems and
Outcome-Based Collaborations Comprehensive collaboration with participants based upon the needs associated with identified outcomes.
“Patient First Always" commitment allows for stake holder identification and participation by agencies. Clear definition of the methods towards cost effective quality health care ( Standard Operating Procedures),