Case Study Management Pl Case Management

Case managers also provide support and information to patients and their families. Next, is utilization review. `Its main objective is to review each case and determine the most appropriate level of services, the most appropriate settings in which the services be delivered, the most cost efficient methods for care delivery and the need for planning of subsequent care. Other methods used for utilization and control are choice restriction and practice profiling' (Douglas, 2003, p.328).

The Case Management program is offered by Kaiser Permanente to support members with complex medical, psychosocial, and care management essentials. This specialized service is provided by case managers. The case managers are either Registered Nurses who are certified in case management or qualified Social Workers. Case managers provide necessary information and education to promote understanding, reduce the chance of possible complications, and facilitate effective and proper delivery of care and services.

How does case management achieve efficiencies in the delivery of health care? How does case management differ from disease management?

In my interview with Stacy she says, “A case managements goals was to meet the needs of the individuals and the families” (Downing, 2015). It all ultimately depended on the situation and how long you have known the family that you typically access the patients and use those challenges to develop a plan in which the patient has helped you formulate. The goal is to in a therapeutic way engage the patient and their families in their own plan or progress in which working within their skill level and readiness to change and build upon the current

In order to, differentiate between utilization management and case management using the seven case management standards, it is first important to define each individual component. To begin with, a key component of quality and cost effective care is Utilization Management (UM). Utilization management is a way to assure that the appropriate care is medically efficient, a suitable use of health care services, proper procedures, and is applicable with provisions aligned in the health benefits plan. Case Management engages quality services in a timely coordination of patients’ specific needs in an approach that promotes positive outcomes by means that are cost effective. Case management may be developed during a single health care setting that may then transition throughout the care continuum. The seven standards are key components that described to maximize benefits and minimize the opposition.

The case management process consists of five parts: assessment, treatment planning, linking, advocacy, and monitoring. It is not a linear process and does not follow the order it is written up. There may be some back and forth and returning to certain points.

Case management is a continuous balancing act of judgment calls, making ethical choices, getting along with coworkers, and following legal protocol. It is the duty of the case manager to know how to develop a relationship with both clients and coworkers while still maintain their professionalism. The healthcare professional must always leave their personal opinions at home and provide the same quality of care to all their clients regardless if they have different views, religion, sexual orientations, or cultures. The case manager needs to ensure that the client’s concerns will be put first no matter what, and should also clarify that the as the professional he or she will do all that is necessary to provide the best quality of care to their client.

Rothman, J., & Sager, J. (1998). Case Management: Integrating Individual and Community Practice (2nd ed.). Boston, MA: Allyn and Bacon.

Case managers play such a key role in the health systems that they are almost considered as the face of patient care.

These are the three models of Case Management that are used The role-based case management, the organization-based case management, the responsibility-based case management. The main reason for the difference of the three is for servicing the clients the best and best taking care of their needs. The role-based case management main goal when working with there clients is make sure their clients is receiving the services in which their client needs. Also another important thing is to make sure each service is doing what’s best for the client. An example of this would be making sure the client therapist, rehabilitation are all working together. The next model is the organization-based case management is for clients who have multiple problems and

The process of using Evidence Based Practice in a patients care plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure effectiveness.

What I understand of case management is that it helps Social Workers in helping their clients, meaning social workers take actions to manage the various aspects of cases they are working on. Case management is also a shared process of assessment, planning, facilitation and advocacy for decisions and services to meet an individual’s need through communication and available resources. Case management examines the person’s physical, emotional, environmental state, and promotes quality and cost-effective outcomes. In addition, in Case management the worker helps to empower the clients to become self-sufficient. Moreover, Case management is structure into six principles

It is our job as Social workers to find and secure the right services for our clients to access. The author states that “once there have been a thorough intake and assessment, one of the next task is making sure that there is enough support to help the client complete the intervention plan” (Ward & Mama, 2006, 143) Case management is combined of many different things such as big and small tasks. Sometimes services are not the right fit for the client we need to adapt and develop a back up plan. The author states that case management is “ the corner stone of social work practice and is one of the jobs most widely available to entry level

According to IC & RC, Case Management is defined as, “activities intended to bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts” (Herdman, John W., 6th Ed.). Case management is a concerted effort of various professionals in the human social services network that assess’, plans, implements, coordinates, monitors and evaluates options required to meet the client’s health and human service needs. It is characterized by advocacy, communication, resource management and promotes quality cost-effective intervention outcomes. The Case Management Process centers on the client and the client’s support system. It is holistic in its approach to the management of the client’s individual and specific situation and that of the client’s support system. It is adaptive both to the case manager’s practice setting and to the healthcare setting in which the client receives services. Case management is not a profession unto itself however; it is a cross-disciplinary and interdependent specialty practice within the health and human services profession. Everyone directly or indirectly involved in healthcare benefits when healthcare professionals and

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,