The Accident Compensation Corporation ( Acc ) And Case Management Society Of America

Thank you for the signed retainer with our firm to handle your Workers’ Compensation Medical Provider Applications. The Workers’ Compensation Court allows us to recover for authorized and emergency treatment on behalf of your patients through the Workers’ Compensation Court. In our experience, most of these cases have been resolved amicably with the insurance carrier. However, there are various issues that we encounter as a part of our representation of Medical Providers in Workers’ Compensation Court.

Case Managers have a challenging job, often dealing with patients, community agencies and facilitating their hospital discharge to the next level of care. They collaborate and communicate with the entire healthcare team and mostly with the patient during the hospitalization process. They act as support for all stakeholders to achieve positive patient outcomes. In this paper, I will be interviewing Ian Mopas, who is a Patient Care Coordinator at Kaiser Permanente in Redwood City about his education, work training, goals, and objectives as a Care Coordinator, and his responsibilities in his organization.

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?

The case management team that I interviewed was Child Life at Riley Hospital for Children. The Child Life management team helps find outside resources and seeks to minimize the stress and anxiety on children and families that are dealing with a lifelong childhood diagnosis. They help children ease their anxiety by providing therapeutic activities that address patient and families social and educational needs during

According to an article published in Case Management Advisor (2008), education assists case managers with being as knowledgeable as possible to identify and coordinate all the resources that their patients need and continued education is an ethical responsibility of a case manager. The article also suggests that advocacy is an ethical responsibility of a case manager. When advocacy is forgotten ethical issues occur. Fraser and Strang (2004) explain that case managers must be given the tools to allow them to function in their role with confidence and competence to act as strong advocates for their patients. Support for decision making is also a key component of case management. Coffman (2001) offers key points from The Code of Professional Conduct for Case Managers advising that case managers are guided by the principle of autonom. Case mangers achieve autonomy through advocacy. If case managers are expected to function with complete autonomy, then case managers require the assusrance that their leader ship will support them when difficult decisions have to be made, (Fraser and Strang, 2004). The concept of employer employees explains that by involving employees in developing the mission and values of the company, this allows employees feel empowered (Porter-O’Grady & Malloch, 2007). By allowing the case manager to be part of the development of the

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.

Case Management Society of America. (2010). Standards of Practice for Case Management. Retrieved from http://www.cmsa.org/portals/0/pdf/memberonly/StandardsOfPractice.pdf

Case managers provide forms stating the rights of the clients and responsibility that the clients have.

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

Case management has case managers who effectively assess my healthcare needs. They also provide support systems to help me. Then, they coordinate, monitor, and evaluate my progress and the services that I receive. It promotes quality and cost-effective interventions and outcomes.

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