The evidence base for case management practice.

Little is known about the role performance of case managers, who come from a variety of professional disciplines. The purpose of this secondary analysis is to identify and compare case management (CM) activities and knowledge elements by professions and by work settings. In an online field survey conducted by the Commission for Case Manager Certification in 2004, 4,419 case managers rated the frequency and importance of 103 activities (8 domains) and 64 knowledge statements (6 domains). Nursing and social work showed a relatively similar pattern as to their role activities and knowledge factors for CM practice. Similar patterns were seen in work settings: between hospitals and rehabilitation facilities; health insurance companies and managed care organizations; and CM companies, workers' compensation agencies, and third-party administrators. These results indicate that there is evidence for how to develop CM programs consistent with both organizational characteristics and strengths of the nursing profession.

Perspectives of an American University of Beirut graduate on nursing scholarship.

Nursing scholarship is necessary for the advancement of the nursing discipline. Engaging in scholarly activities is every nurse's responsibility regardless of job title, position, or practice setting. Scholarship today is no longer limited to the practice of academicians and scientists; rather, it is integral to the work of nurse leaders, clinicians, health policy specialists, researchers, and educators. The scholarly contributions of nurses have been noted at regional, national, even international levels. This article describes a renewed and contemporary view on nursing scholarship and discusses the role of the nurse in promoting the nursing profession using scholarly activities.

The CCMC's national study of case manager job descriptions: an understanding of the activities, role relationships, knowledges, skills, and abilities.

Defining the roles and functions of case managers is crucial in today's healthcare environment and necessary for the case management field. One way to address this issue is through the examination of case managers' job descriptions used in various healthcare organizations. The study reported herein used qualitative analysis procedures and the latent class cluster analysis method to examine a national sample of 1028 job descriptions of case managers. The study identified the activities, role relationships, knowledge, skills, and abilities of case managers working in varied settings. It also described the changes that occurred in the practice of case management, based on these job descriptions, over 5 years: from the mid-1990s until the early 2000s. One benefit of this study was a change in one eligibility criterion of the CCM credential. Another was the development of a taxonomy of case managers' roles and functions that can be used as a step toward standardization of case managers' job descriptions.

Case managers' roles and functions: Commission for Case Manager Certification's 2004 Research, Part I.

The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004. The purpose of this research was to validate the currency and relevancy of the certified case manager examination. The results of this study are shared in 2 parts of an article. Part I discusses the process the CCMC used for the development of the Case Manager's Role and Functions Survey Instrument (CMRFSI). The research leads to the identification of 6 new essential functions and 6 new knowledge areas, which describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the survey results and focuses on identifying the empirical activity and knowledge domains of case management practice, using factor analysis. It also discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, it summarizes future changes in the field of case management as perceived by those who participated in the study.

Case managers' roles and functions: Commission for Case Manager Certification's 2004 research, part II.

The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004 for the purpose of validating the currency and relevancy of the certified case manager examination. The results of this study are shared in an article of 2 parts. Part I, which was published in the previous issue of this journal, discussed the process the CCMC used for the development of the Case Managers' Role and Functions Survey Instrument and the identification of new 6 essential functions and 6 knowledge areas that describe case management practice. These findings were based on the survey of a large national sample of practicing case managers. Part II continues the analysis of the results and focuses on identifying the empirical (statistically derived) activity and knowledge domains of case management practice, using exploratory factor analysis. It discusses the similarities and differences found among various subgroups of case managers who were compared on the basis of certain demographic variables. In addition, Part II summarizes future changes in the field of case management as perceived by those who participated in the study.

Essentials of advocacy in case management.

Advocacy is vital to case management practice. It is a primary professional role of case managers functioning in various care settings and across the continuum of care. Acquiring knowledge, skills, and competence in what advocacy is and how to enact its related behaviors is essential for success of case managers and for achieving desired outcomes for both the clients and healthcare agencies alike. This article describes the use of advocacy in the field of case management and highlights several practical strategies for case managers to apply in their daily practice.

Clarifying certification and its value for case managers.

The field of case management is experiencing a rise in the number of certified case managers and certified (or accredited) programs in case and disease management. However, not every practicing case manager, employer, payer, or client is aware of the value of certification. In addition, there exists some confusion about the difference between "individual" and "institution" certification; sometimes they are erroneously used as interchangeable terms. This article emphasizes the value of case management certification and its necessity, and clarifies the difference between individual and institution certification.

A ten-step process to develop case management plans.

The use of case management plans has contained cost and improved quality of care successfully. However, the process of developing these plans remains a great challenge for healthcare executives, in this article, the author presents the answer to this challenge by discussing a 10-step formal process that administrators of patient care services and case managers can adapt to their institutions. It also can be used by interdisciplinary team members as a practical guide to develop a specific case management plan. This process is applicable to any care setting (acute, ambulatory, long term, and home care), diagnosis, or procedure. It is particularly important for those organizations that currently do not have a deliberate and systematic process to develop case management plans and are struggling with how to improve the efficiency and productivity of interdisciplinary teams charged with developing case management plans.

Motivational interviewing: building rapport with clients to encourage desirable behavioral and lifestyle changes.

PURPOSE/OBJECTIVE: As professional case managers seek to improve outcomes, including the health status of their clients, it becomes imperative to gather and assess as much relevant information as possible to identify and address the client's needs in a holistic manner. Motivational interviewing is a highly effective technique case managers employ for this purpose. They also rely on it to move their clients toward a course of successful, desirable, and sustainable change, such as healthier diet, exercise, self-care, and adherence to medications regime and follow-up care. PRIMARY PRACTICE SETTING: Across the case management spectrum, including hospitals, accountable care organizations, patient-centered medical homes, physician practices, clinics, and other settings in which case managers work with clients and their support systems. FINDINGS/CONCLUSIONS: Motivational interviewing is a highly effective technique for gathering accurate and comprehensive information that is supportive of and additive to the assessment phase of the case management process. Using motivational interviewing, case managers can more readily uncover health and lifestyle needs of their clients. This results in building trusting relationships and developing rapport with clients, which can motivate them to move toward successful and desirable change. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The design and implementation of a comprehensive and effective case management plan of care is facilitated by motivational interviewing, whereby professional case managers establish collaborative, respectful, trusting and individualized relationships with clients. Using the specific principles and techniques of motivational interviewing, case managers take a holistic approach to care to address a client's willingness and ability to change; addressing self-confidence and other emotional triggers that affect change and support the client's ability to embrace and sustain positive change.

Case management roles and functions across various settings and professional disciplines.

PURPOSE: To describe the practice of case managers in diverse settings with special focus on the roles and functions that they engage in during an average work day. Results were also used to validate and revise as indicated in the blueprint of the certification examination of the credential Certified Case Manager (CCM). PRIMARY PRACTICE SETTING(S): The study covered all of the various case management practice settings. METHODOLOGY AND SAMPLE: This cross-sectional descriptive study applied the practice analysis method and survey research design. It also employed a purposive nonrandomized sampling procedure that resulted in 6,909 total participants. Data collection was completed between May and July 2009. The survey instrument used consisted of 209 items that addressed background and demographics, case management activities, and knowledge areas. RESULTS: The case management professionals who participated in this study had similar perceptions of the essential activities and knowledge aspects of their practice except for those who are vocational rehabilitation and work adjustment specialists and those who practice in the life care planning and disability management settings. The study also resulted in the identification of 6 essential activity and 6 knowledge area domains. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: This study described the current practice of case management in diverse settings and by different health care professionals who assume the case manager's role. It also forecasted what practice changes might occur in the next few years. In addition, it identified the essential activities and knowledge areas required for effective and competent performance of case managers. These findings provided the evidence of the CCM certification examination and demonstrated that the structure or blueprint of the examination was developed on the basis of rigorous research. In addition, findings of this study can be used for further research in case management and developing training and education curricula for the advancement of case managers.

One patient, numerous healthcare providers, and multiple care settings: addressing the concerns of care transitions through case management.

Care transitions are a natural occurrence in our healthcare delivery system. During a single episode of illness, patients are cared for in multiple care settings and by healthcare professionals of varied specialties and disciplines. Such dynamic events increase the risk of patients experiencing "poor" quality of care, especially as a result of medical errors and unsafe situations. Care coordination has been emphasized recently as a strategy for enhancing the effectiveness of care during such necessary transitions. This article describes the issue of care transitions and suggests how case management, through care coordination, can play an important role in ensuring safe and effective care transitions.

Identifying and reducing risk of medical errors.

From assessment and planning to evaluation and outcomes, case management is a proactive process that provides access to quality, safe, effective, and timely care. Each step in the case management process, especially when undertaken by a qualified professional provider, may also provide an added and significant benefit-the potential to reduce or to prevent the risk of medical errors.