Professional Case Management最新文献

{"title":"Roles, Training, and Qualifications of Case Managers at Community Integrated Service Centers in Taiwan: A Narrative Review.","authors":"Ya-Wen Kuo, Wen-Li Hou, Jiann-Der Lee, Ching-Min Chen","doi":"10.1097/NCM.0000000000000791","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000791","url":null,"abstract":"<p><strong>Purpose of study: </strong>This study explored the roles, training, and qualifications of case managers in level A of Taiwan's long-term care (LTC) system, established within the Ten-Year LTC Plan 2.0, to identify their challenges and provide recommendations for enhancing their performance.</p><p><strong>Primary practice setting: </strong>This study focuses on community integrated service centers in Taiwan, which serve as key hubs for delivering LTC services to Taiwan's aging population.</p><p><strong>Methodology and sample: </strong>A narrative review approach was implemented, with an extensive analysis of the literature in terms of the functions and training requirements of and the professional challenges faced by case managers in the LTC sector. This review included articles published between 2016 and 2024 in both English and Chinese.</p><p><strong>Results: </strong>Case managers play a key role in linking LTC resources and coordinating care for older clients. However, they often face major challenges, including a high caseload, inadequate training opportunities, and a desire to quit, which adversely affect service quality and outcomes.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gather 'Round: An Integrated Care Model for the Emergency Department Multi-Visit Patient.","authors":"","doi":"10.1097/NCM.0000000000000780","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000780","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"E3-E4"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Managers: Embracing Lifelong Learning.","authors":"Janet S Coulter","doi":"10.1097/NCM.0000000000000773","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000773","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"28-29"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Trafficking and the Role of the Case Manager.","authors":"Jennifer Anderson","doi":"10.1097/NCM.0000000000000776","DOIUrl":"10.1097/NCM.0000000000000776","url":null,"abstract":"<p><strong>Purpose: </strong>Human trafficking (HT) is the fastest growing crime in the world and a major health concern for healthcare. There is a critical lack of healthcare provider targeted HT education, resulting in the failure to identify, rescue, and provide proper care for victims of HT in the United States. All healthcare professionals must be vigilant and proactive in identifying and assisting victims of HT. Recognizing this need, the aim of this paper is to improve case managers' awareness and knowledge of their role in HT.</p><p><strong>Primary practice settings: </strong>The primary setting for purposes of this paper is the hospital as this is the most likely setting where a case manager would encounter a victim of HT. It has been reported that 87.8% of victims report they have been in contact with a healthcare professional at some point during their trafficking with 63.3% occurring in a hospital/emergency room.</p><p><strong>Conclusion and implications for case management practice: </strong>Given the prevalence of HT and the likelihood of numbers growing, case managers should proactively learn to identify, rescue, and provide patient-centered care for victims of HT. This can be achieved through the knowledge of tools that exist to assist case managers in the identification of victims, including the AMP and SOAR models. Additionally, it is important to know one's role, debunk the myths, and recognize the signs associated with trafficking. Providing a collaborative, patient-centered care approach that supports and empowers the victim will lead to improved victim outcomes and may aid the successful prosecution of the trafficker.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"35-38"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on Electronic Health Records.","authors":"Lynn S Muller","doi":"10.1097/NCM.0000000000000775","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000775","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"39-40"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do Medicaid Members Want From Their Health Plan? Insights from a Qualitative Study to Improve Engagement in Case Management.","authors":"","doi":"10.1097/NCM.0000000000000778","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000778","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"E1-E2"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Commentary.","authors":"Ellen Fink Sammick","doi":"10.1097/NCM.0000000000000772","DOIUrl":"https://doi.org/10.1097/NCM.0000000000000772","url":null,"abstract":"","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":"30 1","pages":"30-32"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Management in Prevention of 30-Day Readmission in Post-Coronary Artery Bypass Graft Surgery.","authors":"Annapoorna Mary, Fawaz Mzayek, Leanne L Lefler, Yu Joyce Jiang, Meghan Meadows Taylor","doi":"10.1097/NCM.0000000000000718","DOIUrl":"10.1097/NCM.0000000000000718","url":null,"abstract":"<p><strong>Purpose of study: </strong>Thirty-day readmission is associated with increased morbidity and mortality among postoperative coronary artery bypass graft (CABG) surgery patients. Interventions such as case management and follow-up care may reduce 30-day readmission. The purpose of this article is to report a study on modifiable factors that may have significant implications for case management in the prevention of readmission after CABG surgery.</p><p><strong>Primary practice settings: </strong>The study population included all the adult patients who underwent first-time CABG surgery from January 1, 2013, to January 1, 2016, from a Mid-South hospital.</p><p><strong>Methodology and sample: </strong>A retrospective case-control study was employed to examine 1,712 patients who underwent CABG surgery.</p><p><strong>Results: </strong>The results revealed that patients readmitted within 30 days had a significantly shorter length of stay (LOS) (6 days vs. 10 days; p < .0001), more days in intensive care unit (6 days vs. 4 days; p = .0391), and significantly higher diabetes/renal (4% vs. 1%), infection (17% vs. 2%), and respiratory-related diagnoses (10% vs. 1%; p < .0001).</p><p><strong>Implications for case management practice: </strong>Among these factors, hospital LOS is a major factor that can be addressed through case management in addition to other modifiable risk factors. Understanding modifiable factors associated with higher readmission risk is crucial for effective intervention and case management planning.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"21-27"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do Medicaid Members Want From Their Health Plan?: Insights From a Qualitative Study to Improve Engagement in Case Management.","authors":"Amy McQueen, David Von Nordheim, Tess Thompson, Kayla Manley, Albert J Pool, Matthew W Kreuter","doi":"10.1097/NCM.0000000000000716","DOIUrl":"10.1097/NCM.0000000000000716","url":null,"abstract":"<p><strong>Purpose of study: </strong>Managed care organizations (MCOs) provide case management services to address unmet health and social needs among their members. Few studies have examined factors influencing members' decision to participate in these programs. The purpose of the present study was to describe the life circumstances of Medicaid members offered case management, what they wanted from their MCO, and their perceptions of case management and barriers to participation. Results will inform practice to raise the awareness, engagement, and impact of case management programs.</p><p><strong>Primary practice settings: </strong>Case management offered through a Midwestern Medicaid MCO.</p><p><strong>Methodology and sample: </strong>Adult members who had been offered case management services in the 6 months preceding the study were eligible for the study. Fifteen people from each strata were recruited: members who engaged with case management, declined it, or declined it initially but later engaged ( N = 45). Participants completed a qualitative interview by phone and a brief health survey online.</p><p><strong>Results: </strong>Across strata, only 22 participants recalled engagement with case management. Members described a variety of life challenges (e.g., chronic health conditions, caregiver responsibilities, and limited finances) and services they desired from their MCO (e.g., stipends for over-the-counter health expenses, improved transportation services, and caregiver assistance). Participants identified direct communication, emotional support, and referrals for resources as benefits of case management.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"3-11"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gather \"Round\": An Integrated Care Model for the Emergency Department Multi-Visit Patient.","authors":"April Feld, Matt Carollo, Jere Freeman-Reyes, Susan McCarthy, Mary Ann Lind, Robert Weinstein, Caitlin O'Dea, Maria Joy, Eric J Morley, Paul Aitken, Robert Schwaner, Dominic Giarraputo, Samita M Heslin","doi":"10.1097/NCM.0000000000000756","DOIUrl":"10.1097/NCM.0000000000000756","url":null,"abstract":"<p><strong>Purpose: </strong>Emergency departments (EDs) are a vital component of the United States healthcare system and care for over 130 million patient visits annually. Nonurgent ED visits can contribute to crowding, delays in care, and adverse effects. Many high-utilizing ED patients may present with complex medical, behavioral, and social needs that are not necessarily emergent or urgent in nature. The authors created an Integrated Care Model, called the Multi-Visit Patient (MVP) program, for patients with 5 or more visits to the ED in a rolling 12-month period. The MVP program incorporated an interdisciplinary group of ED leadership and case management (CM) to identify, engage, and intervene with ED MVPs, aiming to improve their ED utilization. Patients received comprehensive screenings for depression, falls, alcohol use disorder, caregiver support, social determinants of health, and more. Based on these screenings, the CM team implemented interventions such as connecting patients with outpatient specialists and linking patients to community-based organizations to optimize stability, wellness, and reduce ED utilization.</p><p><strong>Primary practice setting: </strong>The collaboratively developed MVP program was implemented in the ED of a large, suburban, tertiary care academic hospital.</p><p><strong>Findings/conclusions: </strong>The MVP program identified 221 MVP patients over a 20-month period and successfully connected with 89% of them. Of these 221 patients, 78% (172 patients) chose to engage in the MVP program, with 160 completing their engagement with an outcome. Among the patients who completed their engagement and for whom the study could match separate utilization data (151 patients), the study observed a 57% reduction in ED visits.</p><p><strong>Implications for case management practice: </strong>Case managers play a crucial role in the effectiveness of the MVP program by coordinating comprehensive care for high-utilizing ED patients. The MVP program includes transition of care initiatives designed to improve patient outcomes. Through screenings and targeted interventions, case managers identify and address the complex medical, behavioral, and social needs of MVP patients. This collaborative, interdisciplinary approach underscores the importance of timely and coordinated care, benefiting both patients and the health system. The MVP program exemplifies the critical role of case managers in reducing unnecessary ED visits and enhancing overall patient care.</p>","PeriodicalId":45015,"journal":{"name":"Professional Case Management","volume":" ","pages":"12-20"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}