Case Management

The Philosophy & Guiding Principles of Case Management

 October 8, 2018

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

Case Management Week is a time to honor and recognize all professional case managers across the continuum of care in the United States. Honor and recognition aside, our mission of sharing the philosophy and underlying principles of what we do is one that never takes a vacation. If anything, Case Management Week is the perfect time for folks to tune in and hear our message, when we’re all gathered and at our loudest.

When case managers appropriately manage, efficiently provide, and effectively execute a client’s care, everyone benefits. Our work extends across the entire continuum of health care. What binds it all together is the following principles:

Case management begins and ends with the client.

In order to effectively guide a client through the continuum of care, the client must always be the focus. We must improve our clients’ clinical, functional, emotional, and psychosocial status. How are they faring as an individual patient? How are they faring as an individual in their environment?

Case management is cross-disciplinary.

Case management is not a profession unto itself. It is a specialty practice that is cross-disciplinary. It is an independent specialty practice. Its practitioners come from different backgrounds, including nursing, medicine, therapy, social work, rehabilitative counseling, workers’ compensation, and mental and behavioral health.

Case management is about advocacy.

Advocacy, at the very least, is about support and encouragement. At times, it can be about activism. Along with communication, education, identification of service resources, and facilitation of service, care managers promote wellness and autonomy. We want patients to feel empowered to be their own caregivers. The guiding principles here are autonomy, beneficence, nonmaleficence, and justice.

Case management is centered on clients/support systems.

Case managers remain focused on the whole picture. They commit to the appropriate use of resources, as well as the empowerment of clients in a supportive and objective manner. The clients’ needs may be medical, physical, emotional, financial, psychosocial and/or behavioral. That might not even cover it. Their handling of the clients’ situations must be holistic. Everyone is on board. It is not a linear process.

Case managers must be collaborative.

Entire health organizations will be involved in our work. This means providers, employers, payors and community agencies. The provision of case-managed health and human services must be approached in a collaborative manner. We work together closely for the benefits of clients and their support systems.

Case managers are highly qualified professionals.

One of the hallmarks of a professional tasked with heavy interaction between multiple parties is the ability to create a climate that allows direct, open and honest communication and collaboration. The only way case management services are optimized is when this occurs among the case manager, the client/support system, the payor, the primary care provider (PCP), and all other service delivery professionals and paraprofessionals.

Case managers must also maintain clients’ privacy, confidentiality, health, and safety. This is accomplished through advocacy and adherence to ethical, legal, accreditation, certification, and regulatory standards and guidelines.

To pull all of this together, a case manager must possess the education, skills, knowledge, competencies and experiences to effectively render appropriate, safe and quality services to clients/support systems.

The AdvancedRM Advantage

Our experts understand the complexities that arise from a disability, illness, or catastrophic injury from every perspective: the patient, family member, provider, insurance carrier, attorney involved in complex litigation, and trust fund managers.  

Benefits of Case Management with AdvancedRM:

  • Thorough intake to determine injuries, disability, illness, or needs
  • Evaluation of client and home for proper care and safety
  • Identification of care needs, providers, and caregivers
  • Identification of appropriate treatment programs and community resources
  • Attendance at physician appointments and team meetings to discuss care needs and establish a treatment plan
  • Determination of durable medical equipment and assistance with procurement
  • Organization of home and vehicle modifications
  • Communication with insurance carriers and assist with coverage issues
  • Reports back to family members
  • Assistance with completion of insurance documentation
  • Medication management and oversight
  • Determination of issues to address with physicians during appointment
  • Procurement of medical records, prescriptions, and therapy notes
  • Evaluation of need for home care or alternative placement when additiona support is required

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