How to Organize a Case Management Program

The health care industry deals with patients facing a wide array of challenges. Regardless of the number of problems facing patients, they all expect an efficiently run operation that best serves their individual needs. Case management systems are used to increase your organization's efficiency and delivery of services. In such a system, your staff groups similarly situated patients together and caters to the group's particular needs. For example, common groups that are cared for in such a system are "high-risk" patients. Each group has a case manager that deals with specific patient subsets. After you implement the system, be prepare to work out any procedural problems that exist.

Instructions

• 1

  Assess your organization's specific case management needs. Keep in mind that case management is ideal for handling smaller, similarly situated patients with special needs. Case managers focus on linking early intervention, acute care and community based services for these patients.

• 2

  Obtain consent of your senior management, if necessary, to implement your system. Be prepare to explain the need for the new system, including the idea that having case managers deal with a specific subset of patients with unique needs will increase efficiency, and decrease costs and duplication.

• 3

  Identify patients that will be apart of the case management system. In such a system, you should focus on those patients that would benefit from improved inpatient and institutional outcomes. "Resource intense," or "high-risk" patients are ideal for such a program, because patients in these groups are similarly situated.

• 4

  Plan an implementation schedule and share the case management plan with senior management and staff. Prepare written documents detailing the procedure for dealing with similarly situated patients. Obtain consent for the procedures and educate stakeholders on the coming case management implementation process.

• 5

  Hire qualified staff to run the system. One pitfall is the belief that any nurse can staff the case management system. The role requires special skills such as commitment, clinical expertise, critical thinking skills, flexibility and strong interpersonal skills, among others.

• 6

  Develop outcome measures related to your identified case management objectives. Sample objectives for your organization include cost containment, decreased fragmentation, improved quality and delivery satisfaction among patients.

• 7

  Activate the model in your organization. Once your management and staff are comfortable with the objectives of the case management system, including understanding the purposes of the system, you can implement the program. Make sure that each staff member understand theirs role in the new system. Be prepared to supervise the operation and answer procedural question to newly trained staff who must adjust to the system.