Healthcare case management is a relatively new term but has a vast purview. It involves extensive collaborative processes and various methods of assessments, monitoring, and planning. Also linking to critical and support services, advocacy. It is to meet the complete and diverse health needs of either an individual or a whole family. The way is through available methods of communication. It ensures various things like quality of care, safety. Also, many essential aspects relating to patient comfort. An all-encompassing guidance system. It manages every health need for the individual or the family. It is a specialty practice within the healthcare system. Also, it ensures that the individual needs of the patients are always met.
Healthcare Case Management Systems
There is no chance of a treatment gone awry as it maintains a complete system. The case manager is always aware of the present situation of the patient. Healthcare Case management in any form of illness of the patient takes precedence. Yet, in patients with severe mental illness and disability, it is of prime importance. The patient is completely clueless about the situation and also his/her own needs.
Here the case manager steps in and does the needful. They maintain a complete track record. Then provide further help and advice to cope with whatever the situation may be. As is evident, the person with a mental health condition is often ineligible to make decisions. So the case manager is further handling the decision-making aspect. It is crucial for people with a mental health condition.
In the case of mental illness, the people suffering from it have labyrinthine needs. Healthcare Case management is aftercare provided to the patient via the community. It plays a significant role in providing appropriate management of a chronic ailment. It is essential for individuals with a history of repeated hospitalization. Lack of adequate support from the community is cause for the ‘revolving door’ pattern, which is that of repeated discharge and readmissions. The intensity of case management is according to the seriousness of the case.
Approaches to case management
The models of case management vary in their approaches. (Chamberlin & Rapp, 1991).
There are two leading approaches. One is community treatment teams with an assertive approach, and the other being individual cases for caseworkers. In the case of assertive community treatment, the process is continuous and very intensive. Moreover, the effectiveness of this approach is well documented and backed by hard proof. It has been able to reduce hospitalizations. (e.g Bond et al. 1990, Chamberlin & Rapp 1991, Solomon 1992).
Yet, the majority of cases demand an individual case manager. It is because the needs of any person with a mental health condition are often delicate. The case managers are hence working in direct contact with a client. Some tasks are undertaking assessments, planning, keeping under observation, advocacy. Being the bridge between consumer and support services is one of the most critical tasks. The function of the case manager is clear, managing illness and preventing a relapse. The patient is often incapable of making decisions due to some mental illness. The proper functioning of a case management system becomes all the more critical.
The efficacy of individual case management is a little awry by the record. The best results are if the client to staff ratio is 1:9-20. There has been a notable decrease in hospitalization in such cases. Studies say that a higher caseload means no reduction in hospitalizations. In places where the client to staff ratio is 1:20-40, hospitalizations did not reduce. Managers are unable to provide individual attention. A table indicates the principles involved in effective case management, which help to yield better results.
The present state of case management in healthcare
There is a great shortage of effective case management in Australia. The need far outweighs the availability. Regional areas and also rural, remote places have more of a cause for concern. Accounts exist of patients getting discharged from a hospital without proper planning. Places where case management was available proved ineffective because the manager has too large of a workload.
Most of the patients with some form of serious mental illness had little to no access to a case manager. As a result, the duties the case manager has to perform fall into other people’s hands. These are complex tasks for inexperienced and ill-equipped people. It includes the patient himself/herself, family members, caretakers, and general practitioners. As expected, many caretakers find the case management role cumbersome and feel unsupported. They have insufficient access to proper means, services.
Healthcare case management systems may not be the ultimate solution, but there is no denying its benefits. Therefore, there is a need to put more resources for case management in healthcare. People with a mental health condition need to stay connected with proper clinical, psychological channels. Proper case management alone can ensure this. Only then can they hope to sustain themselves in society.
Table identifying the principals involved in effective case management
Proper adherence to these principles is necessary. It is more than enough to ensure the best patient comfort and satisfaction. They prove effective in reducing the revolving door pattern and decrease re-hospitalizations.
- Case managers themselves deliver as much of the help as possible. That is what case management is. They should not refer to the services of others and create an endless chain of referrals.
- People in the natural environment of the community are the best partners possible. (e.g., gardeners, landlords, artistic clubs, teachers, etc.)
- All work within the community.
- · Whether an individual or as a team, case management works in both cases
- · The patient’s services are the prime responsibility of the case managers.
- It is possible to have paraprofessionals as case managers. But only experienced supervisors with proper credentials.
- The consumer to case manager ratio should be low, i.e., below 1:20. It allows for effective management.
- If needed, the time should not be a limit to proper case management.
- Familiar persons should get access to patients 24 hours a day, 7 days a week.
- Allowing choices to foster is an effective form of case management by case managers.
Thus we should under no circumstances undermine the importance of case management. There is a huge demand for case managers in many areas. Thus this demands quality work and effort in this direction. The aim is to provide effective case management systems, especially for people with serious mental ailments. It will also improve the existing healthcare system.