The Roles of Case Managers in the Healthcare Systems

Table of Contents

Introduction

Case management has become a critical undertaking in contemporary healthcare systems. In principle, Watts, Lawrence, and Kern (2011) define it as a coordinative process that involves evaluation, plan development, care facilitation, provision of healthcare advocacies among others. The provision of case management is based on the fact that all healthcare stakeholders benefit when a single person reaches optimum health. As such, it combines effective communication, educative pursuits, and facilitation of advocacies to attain the mentioned wellness. Importantly, it ensures that the process is cost-effective, efficient, and timely. Since it is a crucial undertaking in healthcare, this paper seeks to discuss the roles of case managers comprehensively.

Coordinates Multi-Disciplinary Groups

In some cases of healthcare provision, diagnosis is conducted by different professionals. These professionals come from diverse disciplines and specializations. This implies that there is a very high possibility of conflicting approaches. Whereas the conflict of approaches might occur, the teams are required to serve a common purpose. The common purpose is necessitated by the fact that the health care professionals are serving the same patients although they have different roles. As such, a case manager is mandated to ensure coordination among the different professionals to achieve the common purpose (Thomas, Wilson & Birch, 2014). This coordination is achieved by the distribution of roles and scheduling. As a result, the professionals have specific roles to tackle. In addition, they have a specific time when they work on the patient. Further, the case manager ensures that the professionals share information about the patient. This helps them to make a decision from an all-rounded perspective and ensure the welfare of the patient. In essence, this s a portrayal that case managers are very crucial when it comes to the issue of maintaining order in multidisciplinary situations.

Ensures Communication among Players

In the introductory statements, it was indicated that case management seeks to ensure effective communication. As a result, case managers are mandated to facilitate effective and precise communication among the players. In this regard, they facilitate the sharing of information among professionals and the flow of information. The flow of information ensures that the patient, his or her family, and the healthcare providers are in contact. In case a patient incurs some changes in the health condition, the case manager should make sure that the professionals are aware. On the other hand, if the healthcare providers raise concerns regarding the health status of the patient, the case manager should relay the information to the patient.

Oversee Follow-Up Consultations

Follow-up consultations are very important when it comes to healthcare provision. The follow-ups help the healthcare providers to understand the real-time response of the patients to medication. As such, the medical professionals can make situational decisions according to the prevalent performance as well as responses. The case managers play a vital role in ensuring that the consultations and follow-ups are effective. First, they develop advocacy regarding the importance of follow-up consultations. This ensures that patients are fully aware of the importance of making follow-ups. On the other hand, he or she ensures that the healthcare providers are available to attend to any consultations. This implies that the case manager is a coordinative intermediary between the patient and the healthcare professionals.

Eradicate Duplication of Tasks

In an earlier paragraph, it was indicated that case managers are mandated to ensure coordination between multi-disciplinary teams. In this regard, one of the critical challenges of dealing with multi-disciplinary teams is avoiding conflict of roles. In the same light, the most crucial hindrance to successful collaboration is the duplication of roles. This is because the duplication of roles implies that the available human resource is not being used exhaustively and effectively. Indeed, the contemporary healthcare system is suffering from a shortage of medical professionals such as nurses (Chouinard, Hudon & Dubois, 2013). As a result, the human resource base is under pressure. Consequently, any duplication of roles may lead to critical inefficiencies in the system. Therefore, the case managers are mandated to ensure that all players have specific roles to play. Every player has mutually exclusive to the others. This situation and arrangement prevents the mentioned duplication of roles and avoids the misuse of professionals. In addition, it eliminates the conflict of scope and approaches when providing care to the patients. As such, it can be concluded that the avoidance of duplication enhances the efficiency and effectiveness of the available human resource.

Conclusion

It cannot be disputed that case management is one of the most relevant and important undertakings in the healthcare system. In a nutshell, it ensures that there is enough advocacy, communication, and coordination among all the involved players. As such, the case managers have the responsibility to facilitate communication, offer facilitation, and coordinate multidisciplinary teams. In addition, they oversee the process of making follow-up consultations to ensure it is effective and efficient. Lastly, they have the responsibility to prevent duplication of roles. As a result, it can be argued that case managers are some of the most critical players in the healthcare sector. They do not only ensure technical efficiency, but they also promote managerial proficiency.

References

Chouinard, M., Hudon, C., & Dubois, M. (2013). Case management and self-management support for frequent users with chronic disease in primary care: A pragmatic randomized controlled trial. BMC Health Services Research, 29(1), 49-49.

Thomas, R., Wilson, D., & Birch, S. (2014). Examining End-of-Life Case Management in Systematic Review. Nursing Research and Practice, 30(3), 1-14.

Watts, S., Lawrence, R., & Kern, E. (2011). Diabetes Nurse Case Management Training Program at Enhancing Care Consistent With the Chronic Care and Patient-Centered Medical Home Models. Clinical Diabetes, 19(12), 25-33.

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