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The Roles and Responsibilities of a Case Manager in Healthcare

Introduction

The roles that nurses play in the healthcare sector increase concurrently with the overall requirements of the industry. In today’s healthcare scenarios, nurses perform tasks that they were not traditionally required to complete. Case management is one of the roles carried out by today’s nurses as the healthcare system seeks to improve its ability to provide wholesome care to its clients. Nurses must understand the role’s requirements for them to fulfill their responsibilities effectively. Such an understanding will allow nurses to bring the required professionalism to their cases and apply individualized solutions to each instance that they manage. Understanding and fulfilling the requirements of their roles as case managers, therefore, places nurses in a position to assist the healthcare system in achieving its goal of providing wholesome care to all of its clients.

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Definition of a case manager

Case management is a new facet of care provision, which aims at increasing the quality of the care that patients receive (CMSA, 2010, p. 4). According to the CMSA (2010), this management system requires the input of a team of healthcare experts that works together to increase the efficiency of healthcare interventions (p. 4). Interactions with healthcare caseworkers are, therefore, poised towards the creation of a patient-centric care provision system. In a shift from the traditional provider-centric system, case management engages a variety of case-specific healthcare professionals to ensure that the client can access wholesome primary healthcare services on a case-to-case basis (Birks, et al., 2010, p. 26). Therefore, the case management approach of primary healthcare systems places healthcare providers in a better position to provide wholesome care as compared to the traditional primary care approach.

Although it is a profession akin to any other, working as a nurse places individuals in situations that can cause psychological distress. Nurses in the field are often exposed to issues such as attachment to their patients, which can cause psychological distress as cases progress (Henderson, 2010, p.32). In light of this, the case management approach allows such nurses to have a support structure and reduces the psychological toll of handling patient cases. With this support structure in place, nurses can provide professional care and lessen the effect of emotional and sometimes, unethical reactions to patient cases (Tabak & Zvi, 2008, p. 106). Case managers can, therefore, ensure that their institutions are protected from unethical practices by ensuring that they create effective teams to handle each situation and provide adequate support structures to the practitioners involved in each one.

Roles of case managers

Healthcare professionals play a vital role and are, therefore, called upon to make the right decisions to ensure that their clients receive adequate care. Patient rights are one of the important considerations that nurses should keep in mind when handling cases. For cases involving minors, the case manager should ensure that parents acknowledge their children’s rights and make ethical decisions, and involve the children accordingly (Tabak & Zvi, 2008, 109). According to Tabak and Zvi (2008), such situations often necessitate the involvement of a variety of professionals, and case managers can even include experts from outside the healthcare sector to assist on a case-to-case basis (p. 109). Such involvements are unique to each instance and the case manager is responsible for determining the needs of each particular case and forming a team that supports each other to provide the care that the patient needs both during and after their visit to the healthcare institution.

Case managers in community health scenarios

Although healthcare providers mostly work with individuals in and around their respective institutions, some of them are also tasked with providing communal care. These preventive care providers play a significant role in providing preventive healthcare services and reducing the need for the reactive care provided by their institutions (Birks, et al., 2010, p. 26). These healthcare workers are responsible for providing regular health checks, setting up temporary clinics, and screening for chronic diseases within the communities. To achieve this, the case managers must identify the needs of each community, provide the right staffing mixes, mobilize the right resources and utilize the appropriate delivery plan to ensure that their efforts are efficient and effective (Birks, et al., 2010, p. 26). Such interventions are extremely vital to the healthcare system’s goals of wholesome care provision since they reduce the prevalence of chronic diseases while also providing institutions with the data needed for proper resource management and allocation (CMSA, 2010, p. 25).

Conclusion

Case managers play a very vital, albeit relatively new, role in the healthcare system. They allow healthcare providers to increase the effectiveness of their interventions by allocating the right team of experts to each case. Case managers also ensure that the individual experts who are a part of each team have the necessary support to ensure that their interventions are as efficient and ethical as possible. Case managers handle and plan for the provision of community care, whereby they allocate and manage the human input and resources for each community intervention. Case managers must, therefore, understand their roles and have the necessary management and leadership skills since are crucial in helping the healthcare system to achieve its goal of wholesome care provision.

References

Birks, M., Mills, J., Francis, K., Coyle, M., Davis, J., & Jones, J. (2010). Models of Health Service Delivery in Remote or Isolated Areas of Queensland: A Multiple Case Study. Australian Journal of Advanced Nursing, 25-34.

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CMSA. (2010). Standards of Practice for Case Management. Little Rock: Case Management Society of America.

Henderson, I. (2010). Making the Case for a Clearly Defined Career Structure. Nursing Standard, 32.

Tabak, N., & Zvi, M. R. (2008). When Parents Refuse a Sick Teenager the Right to Give Informed Consent: The Nurse’s Role. Australian Journal of Advanced Nursing, 106-111.

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StudyCorgi. "The Roles and Responsibilities of a Case Manager in Healthcare." July 28, 2022. https://studycorgi.com/the-roles-and-responsibilities-of-a-case-manager-in-healthcare/.

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