Medical case management in modern clinics

Medical case management in modern clinics

Medical case management is a collaboration of different processes recommended to assure the proper medicinal care is providing to injured individuals. The role of “medicinal managers” is often given to patient advocates.

The therapeutic care plan consists of few parameters:

  • Care assessment. The importance of this feature is a key to next medicinal treatment. During this stage assigned medical care manager needs to figure out patient’s condition and health capabilities. There is a difference in the healthcare of children and elderly people that should be taken into consideration.
  • Interview with a patient. The doctor should ask about chronic diseases and specific reactions to medicines.
  • Assignment of the best available medicines and procedures. The manager should discuss and approve this stage of medical care with a proficient doctor.
  • General discussion with patient’s family. They could tell something special about health state of their relative that he could conceal in some personal reasons.

Clinical management is a complex task consisting of many key features. It requires special skills and increased attention to details. It requires a high cooperation among healing care employees and responsible managers.

What is hidden under the “Case Management” term?

It was introduced in the 50’s among a broad range of clinics for patients with mental diseases in Northern America. It meant the same conditions and availability of medicines to all patients despite their demands and refusals. Each patient has to obey to doctor recommendations in an every occasion of injury or illness.

Medical case management has evolved into a diverse profession with own demands. Manager’s education includes a broad range of healing disciplines and additional law study. Each professional should combine high knowledge of a health care filed with human rights and medical legislation. Conversational type of survey together with attending physician can bring the best way to recovery in every injury occasion.

The role of medical case management in present health protection field

Almost every modern clinic has a medical management program. Diverse specialists involved in a process of analysis of patient rights and demands. It optimizes treatment process and builds up a fast effective system of medical service. The good medical treatment administration could reduce client’s length of staying in a clinic and release place for another patient.

In 1983 was implemented the new Medicare prospective payment program which allows reimbursing payments spent on client’s diagnosis or DRG (Diagnosis Related Groups). This system is regardless of what treatment was provided or period of staying in a clinic.

In the UK same type of case management began with the publication of the “Caring People” white paper of the Department of Health in 1989. It pledges to provide an appropriate assessment with professional healing care.

It should be provided alongside with following key employees:

  • Therapist
  • Attending nurse
  • District nurse
  • Case manager (a separate social or a health care employee)
  • Community matron or a social worker

Efficient cooperation and synergy between whole medical care employees could bring necessary results to a treatment. The well-coordinated system of individual care and medicine plans can develop health protection field into one proficient mechanism. Injured people would have fast and optimal diagnosis alongside with professional treatment.

There are 6 key features of efficient case management:

  • Occasion finding (diagnosis, screening etc.)
  • Assessment
  • Care planning
  • Implementation
  • Administration (conversational model between all involved employees and clients)
  • Monitoring and review

These core stages of a treatment are carried out by the district nurse on a daily basis. Implementation and coordination separate elements of health care administration bring stunning results of the treatment quality improvement.

The process of certification

There are special programs for a broad range of famous universities – Science in Rehabilitation Counseling and Case Management, Science in Nursing, Science in Medical Management etc. With bachelor’s degree, you can earn a certification of Accredited Case Manager. You should be a licensed registered possess or nurse and have two years of real healing practice. At the end of certification, the manager should pass an exam. After all stages of education are successfully passed – you able to work as certified Medical Case Manager.

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