Good Case Management Practices

     

In health care, case management is a process that connects patients with health care providers, resources, and services. Directed toward safeguarding that patients receive the best possible care, case management necessitates case managers to maneuver different health care systems and work together with various stakeholders, as well as patients, medical professionals, and health insurers. 

What is meant by Good Management Practices?

A system of health care delivery intended to facilitate accomplishment of expected outcomes within an suitable length of stay

Goals

• Easy access to required services and harmonize care of clients

• Avert avoidable episode of illness

• Control or condense the cost of care

The activities of a Case Manager in Good Management Practices include:

• Identification

• Assessment

• Service planning

• Monitor

• Service delivery 

• Advocacy

The case management process:

Case management is a collaborative process in which a case manager works with clients to confirm they obtain the proper health care in the most cost-effective manner. To accomplish this vital task, case managers characteristically use the following process: 

1. Screening: During the screening process, the case manager assesses a client’s medical records, medical history, and current financial, living, and social support situation. This gives them an overview of the client’s needs and current conditions. 

2. Assessing: In the assessment phase, the case manager conducts more in-depth research and meets with the client to assess their medical condition and conditions. Supplementary tasks include assessing client health insurance, support systems, and treatment response history. 

3. Evaluating risks: In this stage, the case manager estimates the client's risk for particular ailments. The three risk levels are “low risk,” “moderate risk,” and “high risk.” Common factors that are evaluated include existing medical conditions, blood pressure, mental health, and finances. 

4. Planning: The planning stage is when a case manager changes their collected research into a plan of care for their client, which summaries their health objectives, self-care goals, health care options and services, care schedule, and any relevant resources. 

5. Implementing: Once a plan has been developed, the case manager now assists the client implement it by guiding them through it, making sure they appear in appointments and educating them about health care-related issues. This stage is also called “care coordination.” 

6. Follow up: During the follow-up stage, the case manager understands how the client is progressing through their treatment plan by speaking with them, their health care providers, and their personal support network. In some situations, the case manager might recommend for a change in treatment plan or devise substitute next steps, predominantly if treatment is not working as anticipated. 

7. Evaluating outcomes: Finally, the case manager reviews the entire case and evaluates its outcomes. Typical areas of concern include the client’s well-being, health, financial standing, and whether they received appropriate care. 

Case management skills

The case management process involves an intersection of abundant technical and workplace skills. Some common skills that case managers should possess include: 

• Medical knowledge of a wide variety of ailments

• Knowledge of the health care system, including different medical professionals, medical organizational structures, and health insurance providers 

• Project management and coordination abilities

• Communication 

• Empathy 

• The capability to collaborate with others 

Case management example

An elderly patient who recently suffered a stroke might be assigned a case manager at their hospital to ensure they get the ongoing care they need. In this situation, the case manager would act as a liaison between the patient and their health insurer, assess the patient’s current support network, suggest rehabilitation centers, and direct them toward additional resources. Over time, they would monitor the patient’s progress and make sure they attend their medical appointments and take any prescribed medication. 

Case management is all about connecting patients with health care providers, designing treatment plans, and making sure it all gets done on time. 

Student Name: Maryam Sadiq

Qualification: Pharm D

Student ID: 212/1222