The Concept of Case Management in Nursing



 Case management in nursing refers to the long-term care offered to patients by case management nurses. Their main goal is to improve the patient’s recovery process both within the hospital settings and outside to ensure quick patient recovery (Chow & Wong, 2010). It has been used in the United States for more than two centuries to coordinate health and human services. The unique thing about the concept is that case nurses choose to work with specific groups of nurses throughout the process. Nurses collaborate with other clients around the clock to deliver quality healthcare services to their patients. Below is an analysis of how the concept has evolved in the US since it was first introduced in the 1980s, together with how the nurses work hand in hand with other professionals.

  Evolution of the Concept.

 The practice started in the 1980s when it was first gaining popularity across various settings in the care continuum. By then, there were no formal policies to explain what case management was, there were no certifications, and there were no standards of practice (Happell, Hoey & Gaskin, 2012). Nurses, vocational specialists, and social workers applied their intuition and professional skills to offer their healthcare services. According to them, case management nursing was achieved if patients were treated in the same way their families wanted them to be treated. The “Golden Rule” used by then, “do unto others,” encompassed empathy, common sense, clinical experience, compassion and personal relationship skills. The goal was to ensure that patients enjoyed a quality and safe healthcare, in the right place, at the right time, and at the most-cost effective price.

 In the 1990s, there was more order when the early leaders formed the CMSA (Case Management Society of America) whose goal was to support the practice through legislative involvement, educational forums, and networking opportunities. Exams were introduced together with specific criteria for certification. Organizations like American Nurses Credentialing Center were formed to challenge case management nurses by testing their knowledge. In 1995, the Standards of Practice were formed by CMSA. The standards demonstrated to physicians, legislators, nurses, etc. what case management practice was all about.

 Currently, the Standards of Practice ease the work of hospitals, independent case managers and managed care organizations because they help them to build procedures and policies fit to offer safe healthcare services. The concept has spread throughout every aspect of the healthcare system. Professionals are recruited into the field from various disciplines to sustain the practice (Huber, 2013).

 Collaborative Work between Case Managers and Other Professionals.

 Case managers don’t work in isolation. Instead, they work with other professionals, from other fields to ensure patients receive a whole package of healthcare services. They collaborate with physicians, caregivers, patients, payers, governmental agencies, social workers, the community and other practitioners in offering their services. For example, a case management nurse needs a physician to help maintain, restore, and promote human health since it’s the physician who prescribes medication fit for a given patient (Bernstein et. al, 2010). The nurse’s work is to ensure the patient maintains observes the prescribed dosage and in the case of any emergency; they call for extra attention from the physician. They also work hand in hand with governmental agencies because, in most cases, they are the ones concerned with certification of the case nurses. This is how they interrelate with other professionals to ensure care delivery is a success under this concept.