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Case Management

On November 22nd, 2019, Posted by Lifesaver Essays

  Introduction

Case Management is a combined procedure of scheduling, valuation, assistance, progression, care synchronization, appraisal and backing for opportunities and amenities to encounter an individual’s and family’s complete health requirements by communication and accessible possessions to endorse excellence and profitable results (Barthe-Delanoe, et al, 2012). Case management proves to be a medium for accomplishing client well-being and autonomy through backing, education, communication, documentation of service resources and service amenities as well. The case manager in charge of the case aids in discovering the suitable providers and amenities throughout the range of facilities, while making it certain that accessible possessions are being utilized in a judicious and profitable way in direction to acquire finest assessment for both the client and the compensation source.

Case managers are identified as veterans and important contributors in the care harmonization team, the ones who authorize and encourage people to comprehend and access excellence and effective health care. Furthermore, defining the receivers of case management interferences, the word support system is accounted. Therefore, this support system is identified by each client and it encases genetic relatives, partners, spouses, friends, colleagues or a person related; who supports the client (Rosemann, et al, 2015).

The continuum of health care shields the distribution of health care done during a period of time and it could talk about the care delivered from birth to expiration of life. There are different levels of healthcare management and delivery (Ogden, 2012).

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This is the case of Mr. William Doe who has been referred to this service. He is 82 years of age, lives in Echo Valley and has been diagnosed with many problems like early stages of dementia(Somme, et al, 2012) due to which he is incapable of getting washed every day and doesn’t eat properly. He has a slipped disc back and because of that he isn’t able to lift heavy objects. As the case manager of the Community Health program, his case has been taken into consideration. The paper would share theoretical framework and functions which would help in the assistance and enhancement in the case of Mr. Doe. There are prospective steps given which, if implemented, can help to improve and enrich his deteriorating state.

Standards of Practice for Case Management

In today’s age and time, the standards of practice for case management have evolved over time. With respect to the existing healthcare environment, the growing participation of the people and the caregivers in the administrative process, decreasing disintegration of care in the healthcare distribution system, growing the case management character to cooperate inside one’s training location to upkeep supervisory obedience and enhancing safety of clients and satisfaction are some of the provisional standards to increase the credibility and worth of case management in relation with the current health care environment (Rosenheck, 2014).

Philosophy and Guiding Principles

The fundamental perception of case management is based on the fact that when a person reaches the finest level of wellness and serviceable competence, each person profits: the persons being attended to, their maintenance systems, the health care delivery systems and the several compensation bases also. Case management proves to be a medium for accomplishing client well-being and autonomy through backing, education, communication, documentation of service resources and service amenities as well. The philosophy of case management is such that underlines the commendation that the people, particularly the ones who are suffering disastrous wounds or harshly long-lasting disease, must be assessed for case management services (Bratton, 2012). However, in accord with the case management philosophy, when healthcare is properly and proficiently delivered, each and every party associated with it benefits. The delivery of case management is to work collectively with the healthcare services in order to serve the care receivers with the services that can benefit them and are satisfactory. This would eventually augment loyalty to the care plan and fruitful consequences.

Guiding Principles

The guiding principles are appropriate and significant ideas which explain or monitor the practice. These principles include the usage of client centric and a collective partnership methodology. At any time probable, to help and assist self-government as well as self-care with the help of doctrines of encouragement and mutual decision making, practice of a comprehensive and complete methodology and to run through cultural capability with responsiveness and reverence for assortment. Endorse optimum level of client safety and take professional prominence into account while upholding competency in the practice (Huber et al, 2014). These guiding principles are based on the requirements and principles of the client and are achieved in harmony with all the care givers and service providers.

Case Management Roles, Activities and Functions

Case managers must properly comprehend their roles, activities and functions. Describing these words is important to deliver a transparent and clear understanding of the activities, roles and functions of case managers. When one talks about the roles, these are the set of characteristics and anticipated outcomes which are related with an individual’s position in a communal arrangement. When we talk about the activities, it is a distinct task or act which a person executes to discourse the opportunities of the role expected (Center, 2012). The function is a cluster of various specific actions and tasks within the role.

When the case manager considers the roles, these include various functions wherein every function is labeled as a specific activity. However, these are the job descriptions of the case managers. Case manager must understand the roles, activities and functions in a detailed and specific manner because successful and fruitful outcomes cannot be accomplished without specialized proficiency. There are various role functions of case managers that encase executing a complete calculation of client’s health and psychosocial necessities encasing the health literacy status and shortages, and develop a case management plan collaboratively with the client and family. Arranging with the client or the family, the chief care provider, several additional health providers and the community services in order to make the most of on healthcare responses, quality and cost-effective outcomes

Assisting communication and harmonization amid the people of the health care community encases the client in the policymaking process in order to mineralize the disintegration in the services. Authorizing the client to resolve difficulties by exploring choices of care at any time available and substitute plans, as and when essential, in order to accomplish the anticipated consequences. Heartening the suitable usage of health care services and endeavors to enhance superiority of care and preserve cost efficiency centered on the case.

Components of the Case Management Process

Case Management process is executed inside the ethical and legitimate jurisdiction of the case manager’s possibility of practice taking into account the critical philosophy and proof based familiarity into being. Case management is neither a lined nor a one way application. Valuation accountabilities would arise in the process and the functions like synchronization, enablement and partnership would take place during the course of the client’s healthcare happenstance (Low et al, 2011).

Case management Process in accord with the Case Study

The steps in the case management process with reference to the Case Study given include:

  1. Client identification and selection:

The case manager centers the consideration on the recognizing clients who would profit from case management services. As a case manager, the considered case study is of William Doe wherein he would benefit from the case management services. Aged 82 years, he is a semi-skilled laborer who retired when he was 60 years of age because of the back problems and he also suffers from a slipped disc. His wife died a decade ago and he hasn’t married anyone else since then. He has two children, a girl Zelda who is married and son John who works overseas. William has been identified with hindering airways sickness and early stages of dementia. He can do the mundane errands at home but his condition is deteriorating day by day about which, his children are not aware of.

  1. Assessment and problem identification

Once the case has been selected, wherein William Doe is the one who needs healthcare and community services at Echo Valley; he has a slipped disc in his back and deterioration of the spinal column. Due to these aliments the outcome is continuing pain and restricted movement. He is not able to carry heavy weight or bend for a long time. From the perspective of a case manager, he needs attention as he seems to be in a depressing state of mind and condition. He hasn’t had much communiqué with his neighbors as they are young and he is old, also, he cannot communicate much with people because of his deteriorating physical conditions. Suffering from the early stages of dementia, he is not able to eat properly and isn’t washed regularly. He requires better healthcare services because he is running out of money and he needs care as well as attention.

  1. Development of the case management plan

Accomplishing objectives of the plan and centering the client’s necessities and requirements and determining the services in order to achieve the aims and objectives:

Placing William Doe at the centre of the service response to make certain that the plan is designed to meet his needs and requirements considering his feedback and needs so that a proper structure and framework is developed. Successfully trying to reach out to the children of Mr. Doe, so as to harmonize in this approach with genetic relationships assistance

Gaining the willingness and support of Mr. William Doe to participate with the services

This is known as an intake case management process wherein the case manager tends to identify the requirements of the client in accord with his appropriate response. There isn’t a strict notion through which the presenting requires evaluation. As soon as the requirements and needs are conversed and prearranged, entitlement is conversed upon and the evaluation process begins. As a case manager of Community Options Program, must build a positive relationship with Mr. William Doe, in order to build a respectful and friendly arrangement. Working with Mr. Doe and comprehending his necessities and discovering what would be needed to bring fruitful outcomes.  Come across the prospective risks so that the safety of the client is kept intact (Harrington et al, 2012).

  1. Implementation and coordination of care activities

Firstly, as the Community Operations Program case manager, William Doe would be assisted with the services of Home and Community Care. These are the services which are structured to help the people who are old and suffer from disabilities as well as deteriorating conditions. HACC provides an assortment of fundamental services to upkeep the aged people who face difficulties with the daily tasks and who require support and reassurance to live self-sufficiently in their community. HACC includes multiple services ranging from domestic assistance, home maintenance, nursing care, meals, centre based day care, social support, transport, client care coordination, advocacy, counseling and information as well (Cobbe, et al, 2013).

HACC case management utilizes the client centered model wherein managing and taking care of clients, their healthcare and needs are enabled to upkeep optimum level of independence in the community (Robinson et al, 2012). This model is a collective practice of assessment, implementation, and review, care planning and monitoring the case. In the stage of assessment, Willa doe’s issues, requirements and strengths would be negotiated. His background with his genetic relationships, life domain areas and several other engagements would be researched.  Once the information is tracked, involvement of Mr. Doe is executed, engagement of HACC services would be carried out at the same time up-keeping the process of complete assessment in an effective manner, considering feedbacks and finally concluding the further course of action.

After which, case is planned to finally execute it. Mr. William Doe’s condition is deteriorating and with the help of HACC, short-term and long-term goals are identified and it is made certain that the goals are Specific, Measurable, Achievable, Representative and Timely (SMART). Capitalize on the strong point of Mr. Doe and their networks while defining activities about him and the abilities of HACC.  Communicating with Mr. Doe about his necessities and how it can be achieved. Share the prospective plan with him so that he can engage in the process and help to improve his own condition. Talk together about the priorities and the time frame to achieve the set objectives and goals for the betterment of Mr. William’s condition. It is important that there is clear communication and proper engagement with the client and his relationships as well as family members. This would bring about a transparency of his background and of his nature, how he is and how he can assist in benefiting his own condition (Lewin, et al, 2014).

  1. Practitioner Roles and Responsibilities

While executing the case of Mr. William Doe; it involves a focused and cautious activity with the engagement of and for the benefit of Mr. William. Being action oriented, and working from an assets standpoint encase the client’s right to self-government. As a case manager, it is required to delve into the metrics and to discover options as well as possessions to successfully device the case plan.

A proactive and logical approach would help in accomplishing the case objectives. Trying to maximize the consequences by working in coordination with the client would be of assistance. Discovering the significance of the scheduled time that is recognized and working within that time is advised.  When the plans do not work accordingly, restructuration is prudent. Referral and Advocacy is an important responsibility carried out as a case manager. On behalf of Mr. William, the case manager will have to advocate making it certain that the backup and involvement of services are done sufficiently (Gilleard, 2014).

The requirement of the advocacy and the explanations of the engrossment are serious. Collaborating and harmonizing of services in order to construct relationships with other service providers to upkeep proficient work in direction of the case plan objectives is prudent. Making it certain that HACC is aware of the engagement of the client and discovering the deterrents and gaps, to facilitate it in a positive manner is a chief responsibility.

Communication and information sharing, the case manager must have a clear mind and transparent communiqué channels with all the service providers along with Mr. William, to help them with the tasks to be embarked on because frequent communication helps to preserve a harmonized focus on accomplishing outcomes and meetings with all the service providers as well as the beneficiary client. Cultural considerations are to make certain that engagement and awareness of the client in each and every characteristic of implementation is required.  Advocacy: we live in a place where in every one of us notwithstanding the age; have the right as individuals (Ronnebaumet al, 2015). It is essential to comprehend the fact that these advocacy rights do not moderate with age. Some of the common rights of advocacy are respect, dignity, privacy and quality care etc.

  1. Evaluation of the case management plan

As the case manager, the motive is to evaluate the status of the client’s necessities and goals. As the case with William Doe, the motive is to evaluate that healthcare and consideration has been provided to William Doe or not, has the outcome been fruitful for him and has he been able to benefit from it, has the condition become better, has he been able to come out from that depressing state of mind or not? These are some of the things which are thought about and considered wherein documenting and acknowledging the process is also done. Identifying barriers and answer back to change, in the evaluation process the main objective is to chalk out whether the outcomes have been fruitful for Mr. Doe or it hasn’t changed. If yes, the entire plan is taken ahead accordingly but if not, the strategies are changed so that Mr. Doe can live a life with proper healthcare and medication which comes with fruitful results. Make a survey which encases questions that can chalk out client satisfaction, focus group and focused evaluation as well (Zawadski, 2014). Take the time required to discover the backup of the services like the benefits from HACC, recognize the accomplishment and the challenges as well as prospects for impending partnership.

  1. Closure of the case management process

Once the closure of the case management process comes into being, Mr. William would be in good shape and condition along with the healthcare services provided to him. Also, this stage would only take place when the optimum level of satisfaction has been achieved and the requirements and necessities of Mr. Doe have been fulfilled.

Standard Confidentiality and Client Privacy

Case manager must stick to the legislative laws and the policies and act in accord with Mr. William Doe’s best interest. Case manager must make it certain that the confidentiality and privacy of the client is preserved and maintained properly. Once employed, all the rights and legislative laws must be strictly followed in order to upkeep the standard confidentiality and client privacy.

Ethics

Case manager’s role in the case management is also to behave in an ethical manner and acting in accord with the creeds of the code of ethics. Along with mindfulness of the five fundamental values and how they are functional: independence, benevolence justice, no-malfeasance and reliability. Preserve the relationships and acknowledgement of laws, regulations and advantages.

Conclusion

With respect to the initiatives as a Case manager at Echo Valley Community Health Care along with the help of Home and Community Care program, Mr. William Doe has been critically examined, assessed and his case is acknowledged with importance and solemnity. As he was eligible for the services and was referred to HACC by his local doctor, a detailed case management process had been done by the case manager delving into detailed metrics of the case. Initiatives have been taken to enhance and improve Mr. Doe carrying out all functions, responsibilities, advocacy and all the necessary steps (Brown, 2011). The intention of the case manager was to assist the individual and his family to improve his condition. The outcome of the case management, if done step by step would be stability and improvement in the condition of Mr. William Doe. Theoretical and detailed functions, as well as responsibilities, have been incorporated into this case management to enhance the service delivery to the client’s interest and to achieve client satisfaction.

 

References

Barthe-Delanoë, A. M., Truptil, S., Stühmer, R., & Benaben, F. (2012). Definition of a nuclear crisis use-case management to s (t) imulate an event management platform. In Proceedings of the 7th International Workshop on Semantic Business Process Management (SBPM 2012) (Vol. 862).

Bratton, J., & Gold, J. (2012). Human resource management: theory and practice. Palgrave Macmillan.

Center, D. R. (2012).Health Department. Community Health919, 731-1000.

Cobbe, S., Nugent, K., Real, S., Slattery, S., & Lynch, M. (2013). A profile of hospice-at-home physiotherapy for community-dwelling palliative care patients. International journal of palliative nursing.

Gilleard, C. (2014). Community care services for the elderly mentally infirm. Care-giving in dementia1, 293-313.

Harrington, C., Ng, T., LaPlante, M., & Kaye, H. S. (2012). Medicaid home-and community-based services: impact of the affordable care act. Journal of aging & social policy24(2), 169-187.

Huber, S., Lederer, M., & Bodendorf, F. (2014).It-enabled collaborative case management—Principles and tools. In Collaboration Technologies and Systems (CTS), 2014 International Conference on (pp. 259-266). IEEE.

Lewin, G., Allan, J., Patterson, C., Knuiman, M., Boldy, D., & Hendrie, D. (2014). A comparison of the home‐care and healthcare service use and costs of older Australians randomized to receive a restorative or a conventional home‐care service. Health & social care in the community22(3), 328-336.

Low, L. F., Yap, M., & Brodaty, H. (2011). A systematic review of different models of home and community care services for older persons. BMC health services research11(1), 93.

Ogden, J. (2012). Health psychology. McGraw-Hill Education (UK).

Robison, J., Shugrue, N., Porter, M., Fortinsky, R. H., & Curry, L. A. (2012). Transition from home care to nursing home: unmet needs in a home-and community-based program for older adults. Journal of aging & social policy, 24(3), 251-270.

Ronnebaum, E. D., & Schmer, C. (2015). Patient Advocacy and the Affordable Care Act: The Growing Need for Nurses to Be Culturally Aware. Open Journal of Nursing5(03), 237.

Rosemann, M., & vomBrocke, J. (2015). The six core elements of business process management. In Handbook on Business Process Management 1 (pp. 105-122). Springer Berlin Heidelberg.

Rosenheck, R. A. (2014). Organizational process: A missing link between research and practice. Psychiatric Services.

Somme, D., Trouve, H., Dramé, M., Gagnon, D., Couturier, Y., & Saint-Jean, O. (2012). Analysis of case management programs for patients with dementia: a systematic review. Alzheimer’s & Dementia8(5), 426-436.

Zawadski, R. T. (2014). Community-based systems of long-term care. Routledge.

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