Collaboration for Improving Outcomes- Case Management Implementation Plan

Use your chosen chronic illness/disease from competency one.  Imagine that case management is not being used for your chosen illness/disease. Create a plan to use case management at your workplace to help individuals with this illness/disease.  What is your plan? Identify people within your organization who are stakeholders or would support your plan to use case managers for this population.  Whose support do you need to get your plan implemented?  How will you get their support? Identify your goals – what do you hope to accomplish with your case management plan?

Often, starting with our goals helps – it’s a backwards design.  As we think about a case management plan we are proposing for our workplace, what do we want to accomplish?  Remember – goals should be measurable.  For example, if the chosen chronic disease is diabetes, one goal may be:

·         Clients will have decreased incidences of hyperglycemia requiring hospitalization

Once we determine what we want to accomplish, we can begin to construct our plan to achieve the goal.  To achieve this goal, our plan may include providing education in a manner the client can understand (being sensitive to cultural needs), access to phone support, or inputting glucose readings into their electronic health record for documentation the case manager can evaluate and use to reach out to the client. 

To put this plan in action, whose support would we need?  Primary Care Physicians, Utilization Review personnel, and the Chief Financial Officer would all have an interest in optimizing patient health and reducing costs.

Reading and Resources

• Watch Video Case Management Rubric Tips for Assignments
• Read Kohl, S., Schoenfelder, J., Fugener, A., & Brunner, J. O.  (2019).  The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals.  Health Care Management Science, 22(2), 245-286.  http://dx.doi.org/10.1007/s10729-018-9436-8
• Search the site for US Department of Health and Human Services “Hospital Compare” and use the interactive database to compare and contrast health plans, hospitals, etc. How might you use this site with patients as a case manager?