07.10.2019 - By Dr. Dawn-Elise Snipes
Increasing Case Management Effectiveness
Dr. Dawn-Elise Snipes PhD, LPC-MHSP
Executive Director, AllCEUs Counseling Continuing Education
Host: Counselor Toolbox and Case Management Toolbox Podcasts
Objectives
– Identify the benefits of case management
– Explore the impact of ineffective “standard” treatment
– Identify goals of the case manager
– Review the research identifying the most helpful factors in case management
– Review assessment areas
– Explore common needs of CM clients
– Describe characteristics of effective care plans
Intro
– CM can be defined as a “coordinated integrated approach to service delivery, ongoing supportive care and help to access resources for living and functioning in the community”
Why Case Management
– Frequent users of healthcare services are a small group of patients with multiple chronic conditions and psychosocial and mental health comorbidities accounting for a high number of healthcare visits
– Frequent use of services is often considered a symptom of gaps in accessibility and coordination of care.
– These patients are more at risk for incapacity, poorer quality of life and mortality.
– Case management (CM) is the most frequently implemented intervention to improve care for frequent users of healthcare services and to reduce healthcare usage and cost
– CM interventions resulted in decreases in ED use and cost, a better use of appropriate existing resources, and a reduction in social problems such as homelessness and drug and alcohol abuse
Impact of Ineffective Treatment
– Treatment dropout
– Continued illness
– Work impairment
– Financial problems
– Relationship impairment
– Impaired parenting
– Stress related health problems
– Development of (additional) mood issues
Case Example
– John has a substance use disorder, major depressive disorder and hepatitis C. He doesn’t know how to afford his medication for hepatitis or his depression, has a history of suicidal ideation and has a history of relapse. Currently he is living in a local motel. He recently lost his job and got a DUI.
– Counselors review your provider administration manual. Most insurers offer care/case management programs.
– http://www.aetna.com/healthcare-professionals/documents-forms/bh-provider-manual.pdf
Goals
– Increase/maintain client engagement/motivation by:
– Improving health literacy
– Identifying and addressing obstacles (payors, transportation, language/literacy, childcare)
– Identifying and enhancing strengths
– Serving as a healthcare guide
– Providing support and encouragement
– Reducing symptoms
– Reducing the burden on caregivers thereby improving the psychosocial environment (emotional support, social support, domestic help, insurance, transitional services)
– Increasing confidence in caregivers and clients for self-management
Helpful Factors in Case Management
– Helpful Factors
– Access to medical, social and community resources
– Calm and trusted case manager
– Case manager with strong relationships to referral sources
– Effective communication between CM and treating clinician(s) via a unified treatment strategy
– Multidisciplinary care plan
– Life skills coaching
– Frequent contacts with care provider
– Regular review of the care plan with the client
– Assistance with healthcare navigation
– Patient education/Health literacy enhancement
– Coordination and prioritization of care
Assessment Areas: Client and Caregiver
– Emotional needs
– Cognitive functioning
– Physical complaints
– Sleep
– Current physicians, medications, diagnoses and treatment plans
– Motivation
– Knowledge about the condition
– Health literacy
– Access to safe housing
– Access to healthy meals
– Ability to p