Case Management Process Definition
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The first step in a case management process flow is to determine if the case needs the process at all.
Case management process definition. Payor based case manager may implement the case management process for a client upon direct contact via the telephone by the client support system or upon referral from other professionals working for the payor organization such as a medical director a claims adjuster a clerical person or a quality performance improvement specialist. Business process management bpm is a discipline in operations management in which people use various methods to discover model analyze measure improve optimize and automate business processes. Definition of case management. The definition of case management notes the focus upon.
Case management is a collaborative process of assessment planning facilitation care coordination evaluation and advocacy for options and services to meet an individual s and family s comprehensive health needs through communication and available resources to promote patient safety quality of care and cost effective outcomes. Case management is a collaborative process of assessment planning facilitation and advocacy for options and services to meet an individual s holistic needs through communication and available resources to promote quality cost effective outcomes. Finally a workflow or business process needs to take place to move the case to its outcome. Case management society of australia.
The information will need to be grouped together and made accessible in a suitably controlled way to all who are involved in the case. This section will break down each step into more detail. Any combination of methods used to manage a company s business processes is bpm. What is a nurse case manager.
Definition of case management. The process consists of several steps or sub processes that are iterative cyclical and recursive rather than linear in nature and applied until the client s needs and interests are met. Often working with a specific type of patient requiring ongoing medical care e g geriatrics hiv aids or cancer patients the case management nurse collaborates with other medical professionals to create and implement a long term care plan that insures a patient gets the. A case management process is robust enough to meet sudden changes in a complex case.
Case management body of knowledge website defines the case management process as the context in which case managers provide health and human services to clients and their support systems. Case management process steps. Processes can be structured and repeatable or unstructured and variable. An enterprise content management ecm or document management dm system may also be used to manage case information.
Definition of case management. Case management in health care delivery systems is a collaborative practice including patients caregivers nurses social workers physicians payers support staff other practitioners and the community. It is characterized by advocacy communication and resource management and promotes quality and cost effective.
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