Case Managers: The Case Management Process

Case Managers are a very important factor throughout a patients stay in the hospital. Case managers work with a very wide range of people who differ in age, health issues, and even in difficult situations. Case managers must decrease the hospitalization of the patient and also decrease the over use of services, while still keeping in mind that the patient has everything they need to have a successful and positive outcome after being discharged. A case manager has many roles, one might say that “when implemented at its finest exemplar, is the nursing process on steroids” (Zander, 2002). Case manager must also have certain skills, like organization skills, time management, communication skills, compassion, and problem solving skills. Case managers

The case management process starts with screening, which focuses on whether or not a patient would benefit from the services. Which promotes early intervention and achieving the desired outcome. The assessing phase, is the collection of information of the patient which is compared to similar situations reviewed during the screening, like past and current health conditions. The planning phase creates specific objectives that are essential so that the patient’s needs are met. During this phase the plan is “action-oriented, time-specific, and multidisciplinary in nature”(CMBOK). During the implementing phase also known as care coordination, the case manager secures, organizes, and modifies the health and human services and resources that are essential to meeting the patient’s interest and needs. The following-up phase is focused on evaluating the success of the case management plan and the effect on the patients’ health condition and outcomes. Depending on the client’s health condition the transitioning phase is focused on moving the patient across the health and human services continuum. During this phase the case manager makes sure the patient and the patient’s support system is ready to be discharged to go home or to be transferred to another healthcare facility. There is another part of the transitioning phase which is communicating post transition. During this phase the case managers are reaching out to the patients and their support system to see how things are going. Lastly is the evaluating phase, which is determining the results of achieving the case management plan of care and their effect on the patient’s condition. This phase basically focuses on different types of outcomes of care like, financial, clinical, physical functioning, and more. Depending on the depth of the phase, stratifying risk may also be part of the process. In some settings like, health insurance and chronic