Case managers play an important role in our health care system – a role that has expanded greatly over the last several decades. So what does a case manager do? Case managers are professionals who specialize in overseeing and organizing the case management process, which is, according to the Association of Rehabilitation Nurses, "a process of assessing, planning, organizing, coordinating, implementing, monitoring and evaluating the services and resources needed to respond to an individual's health care needs."
What does all of that mean, exactly? It boils down to this: a case manager helps coordinate the care of patients, gathering information from the collection of professionals facilities and services that participate in that care to build a comprehensive overview of the care they are receiving as well as the care they need. That information allows case managers to aid in detecting any gaps in that care and locating the necessary resources to address those needs – assisting patients and their health care team in navigating our fragmented health care system more efficiently for improved access to high-quality, cost-effective care.
So who benefits from the services of case managers? Just about everyone involved in the heath care system gains from putting their high level of expertise in the areas of health and social interventions to use for more efficient heath care management.
First and foremost, patients benefit in terms of more streamlined, coordinated, and effective care. For instance, a case manager assisting a post-operation patient in a short term rehab setting works to ensure that the needs of patients are met, before, during and after their stay in short term rehab by:
- Assessing patients to before or upon admission to short term rehab programs to determine their individual strengths, challenges, prognosis, functional status, goals and need for specific resources and services.
- Developing plans, based on those individualized assessments, that identify patient-centered short-term and long-term goals, as well as the support systems, resources, and interdisciplinary collaboration between rehabilitation professionals that will be necessary to achieve them.
- Identifiying, procuring, and coordinating the services and resources necessary to implement those comprehensive care plans.
- Performing periodic reassessments of care plans, services and the progress of patients to identify and facilitate any necessary improvements.
- Advocating for cost-effective, evidence-based services to ensure quality care for patients, as well as steady progress towards rehabilitation goals.
- Assisting the individual and family in anticipating needs and making plans for a smooth transition at discharge from short term rehab, including recommending and coordinating necessary assessments, preparations and services.
Case managers provide a number of benefits to care professionals, facilities and payers as well, aiding more open and effective communication between everyone involved with each case, helping to identify and eliminate redundancies, gaps and other inefficiencies in care. These improvements, made via more streamlined care coordination and management, lead to better patient outcomes, as well as more cost-effective care.