What is case management?

Case management is a set of tasks involved in working with a client under a case management model.

In healthcare and social work, case managers must first find access to a person they wish to support. So you have to access what the client needs, what the family needs. You need to know what’s going on behind the scenes of the patients, whether there are medical or health issues, so you can provide the right support and coordination. You need to know exactly what is happening with the client.

Management case studies are real-world examples of procedural steps to address concerns and problems that may arise in a specific workplace or organization. Using case studies, students and trainees can apply theoretical concepts to real circumstances. Most case studies are presented in a way that puts the reader in the role of the case manager and has to make decisions that contribute to the solution at all stages of a problem. Almost all case studies require a decision, even if that decision is to leave the situation alone and do nothing.

According to the Commission for Case Manager Certification, case management is defined as a “collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet a client’s health and human services needs.” Case management firms are primarily concerned with the health, well-being and full functioning of the client.

Levels of case management: what does a case manager do

In managing compensation cases, case managers not only work with injured workers and employers in their case management, but also with physicians who assess the cause of the damage and create a treatment plan and insurance companies that are important to reimbursement.

referrals and transfers

The first stage is the admission of the client by the case manager. Upon receiving the referral, Case Managers receive all information about the injured worker, their medical records and application documents, including past and current health conditions, their socio-economic and financial status, health insurance benefits and coverage, and much more. In the information gathering phase, whether over the phone or in person, it is crucial to identify the injured person’s urgent needs and begin to build trust and a relationship.

On-site and over-the-phone health care nurses who are familiar with medical treatment guidelines will deal with all medical aspects of the claim. For the case manager, the initial level is critical to moving forward.

needs assessment

In the second stage, the case manager reviews the documents and information collected during the intake and referral phase. The primary objective of this stage is to identify the difficulties, obstacles and hazards faced by an injured worker and the conditions that led to the injury or illness. For successful rehabilitation, case managers consider the injured worker’s comorbidities and socioeconomic barriers. Within 24 hours, the case manager liaises with the necessary agencies to develop the most appropriate and cost-effective treatment solutions. This ensures that the injured worker’s health improves and he or she can return to work with fewer days off work.

planning of supply

The third stage is critical to the success or failure of an injured worker case. The case manager creates a thorough care plan that addresses the concerns and needs of the injured worker after establishing precise goals and short and long-term rehabilitation care goals. The action-oriented and time-limited plan also establishes the treatments and services needed to meet the needs identified in the needs assessment phase. The case manager reviews all input and approvals from the client, their employer, and their healthcare professionals when creating the case management plan for the care of the client or injured worker. After determining the required services and resources. The case manager is responsible for assigning, conducting, organizing and scheduling care management activities and interventions.

monitoring and evaluation

The case manager assesses and evaluates the complexity and effectiveness of the client’s case management plan, its impact on the client’s health, the client’s understanding of the treatment regimen, and the outcomes of the procedures and medical interventions in the closing phase. A reassessment is made and, where necessary, improvements and suggestions for further care are made. Monitoring the injured person from the time of discharge until transfer to another facility or home care is another important aspect of this stage. The case manager, the casualty, their support system and the other members of the healthcare team must communicate effectively.

The case manager must inform their client about post-transition care and aftercare, and assist them with obtaining medical and disability aids and with scheduled transportation services. During this time, Case Managers are also required to provide regular progress reports that include key information about the client’s well-being, medication intake, any issues or concerns, and any adjustments to the care plan and return-to-work schedule.

Examples of case management

Onboarding new employees

Onboarding new employees is one of HR’s most time-consuming tasks. Onboarding new employees has a positive impact on their engagement, retention and productivity. However, when a company leaves this procedure unchanged, important nuances in the hiring process are missed. The onboarding process has multiple goals, including collecting the required documentation, providing resources and tools, training, and accounting activities.

With the help of case management, a company can ensure that all onboarding requirements are met. With case management software, companies can create checklists and workflows, and automate important tasks. For example, onboarding systems can be automated and integrated into contract management. Signing and storing documents online streamlines record keeping and eliminates inefficient processes like manual filing.

HR leaders can use case management to check new hires on how well they’ve settled in, improving the onboarding experience and increasing new hire retention. Case managers can also evaluate key performance indicators and make adjustments to the onboarding process as needed.

Inquiries and Permissions

In many organizations, stakeholders have to travel a long way to get approval for work orders, time off, or paying an invoice. This can lead to conflicts and bottlenecks in the workflow and severely affect productivity. Requests and approvals are expedited via case management so everyone involved is kept in the loop. The parties involved can communicate and retrieve information via a single interface. Online documents can be signed and kept.

User input initiates the case management process for requests and approvals. The application will be reviewed and signed by the required stakeholders. Staff can follow up with these stakeholders to verify that requests are being processed in a timely manner. It is important to regularly analyze and improve these procedures using clearly defined workflows.

For example, if an employee requests a week’s vacation from the employer, it should be sufficient to obtain approval from their manager and/or Human Resources. In most cases, executives such as the CEO or COO do not need to be involved in such regular requests. Organizations can use tools like a process modeler to map their processes and ensure effective information flow and task assignment.

Case management solutions

Don’t know how to solve a case study? We show you how to solve a case study in eight steps. There are some simple principles for solving case studies in marketing, human resources, finance, collaboration, groups, organizational program, business project, and other areas of industry.

1. Read the case carefully

First of all, you must read the case study carefully.

2. Learn everything there is to know about the topic.

In a second step, you have to familiarize yourself with the topic.

Familiarize yourself with the characters and the main people involved in the case.

3. Get a picture of the main problem or goal.

Make an effort to understand the problem statement of the case study.

Have an idea of the basic need, problem, or goal of the case study.

4. Go through them again.

Read them again.

Make a model of the core need, problem, or goal that should be included.

Facts that are important and relate to the problem and goals.

5. Name the claims

List the statements that help further define the problem, the goals, and the nature of the problem.

6. Recognize the context of the case study

By noting insights, limitations, opportunities, resources, etc., you can better understand the context in which the case is set.

7. A real life problem!

There are real life situations for which you rarely have all the information or time.

8. A loophole and an educated guess

Determine the information gap and make a reasonable guess given the circumstances. You should sharpen your ability to make time-bound decisions.

What is dynamic case management?

Dynamic Case Management (DCM) is a process in which case-related tasks are handled using technology to automate and simplify various components of each case. A case in this context is a collection of information about a specific issue, e.g. B. a person, a company, an event or a problem.

Informatik Aktuell has addressed the topic in a detailed article by the two authors Katharina Hersztowski and Matthias Steding, which can be read here.

Further education: Certificate of advanced Studies (CAS) – Case Management

For people with professional experience in the field of case management in social and health care with a tertiary degree in Switzerland (technical college, university, ETH, higher technical school, federal professional examination, federal higher professional examination) the degree “Certificate of advanced Studies (CAS) – Acquire Case Management”. Interested parties without a tertiary degree can be granted access to further education via a standardized admission procedure («sur dossier»).

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