If you work in the healthcare industry, you might be aware of the term “case management”. This is a process wherein you will be planning, coordinating, and reviewing the medical records of a patient, and attending to their health issues.
Case Management for Complicated Health Issues
Case management services work best for patients suffering from serious or chronic health issues. You cannot be a case manager to any patient. Certain protocols need to be followed, after which you can offer the right treatment plan to your patient
If you are planning on implementing case management services in your hospital, you can begin with case management for complex health issues. Chronic or serious health issues such as cancers are expensive to treat and contribute to 85% of the cases in most hospitals. Continuous monitoring of the health of such patients and offering the right treatment can help ease their burden and improve the quality of their life.
So, you might be wondering what exactly goes into case management.
This process comprises several steps such as:
- Risk Evaluation
- Implementation and Follow-ups
The first phase involves carefully screening the medical records of your client. In addition to this, you also need to consider their financial stability and their social support system. You cannot offer an expensive treatment plan to your patient if they are not financially stable.
Next comes the assessment part. Here, you will need to meet your client and understand their circumstances. You can check for medical insurance and see how best you can help your client get the best treatment plan.
Now, that you have assessed your client’s overall circumstances, you need to categorize them based on the risks involved. Risk management can be broadly classified as “low risk”, “moderate risk”, and “high risk”.
So, how do you know which category your client falls under? Simple. You need to evaluate their mental health, their finances, and the extent of their medical conditions.
Once you have evaluated all the risks involved, you next need to plan the right treatment plan for your client. This involves, setting their objectives, the health care options, and the appointment schedules.
Last, but not least, you need to ensure that your client sticks to the treatment plan and attends all the appointments at the scheduled time.
So, what happens, if any one of the criteria of the client is not met? Say, for example, your client is suffering from anxiety or depression, or any other mental issue. In such cases, as a case manager, it becomes your responsibility that you offer the right psychological support such as counselling to ensure that your client is at ease.
You will need to coordinate with the counsellors, explain your client’s condition and fix an appointment between them. You also need to review the current progress and update their case management files.
Skill Sets Required for Case Managers
The case management process requires certain skills and knowledge on your part. Certain skills that can help you become an efficient case manager include:
- Thorough medical knowledge of various medical conditions
- Good communication skills
- Good networking skills across various healthcare departments
- Information about various healthcare insurance
- Ability to build relationships
- Offer empathy and support to your clients
Your job does not end by ensuring that your client has the best treatment plan. Once the client has completed his treatment or is discharged, you will need to close the case too. This involves ensuring that the discharge formalities are completed, the medical records have been updated, and the medical insurance has been provided.
Case management services are all about ensuring that your clients are well-taken care of. As a case manager, it can help you improve the health outcomes of your clients, thereby improving their quality of life.