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What are the most effective case management models you've used?

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Case management is a collaborative process that aims to coordinate, monitor, and evaluate the delivery of services to meet the needs and goals of clients. There are different models of case management that vary in their approach, focus, and intensity. In this article, you will learn about some of the most effective case management models you've used and how they can benefit your practice.

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1 Strengths-based model

The strengths-based model of case management emphasizes the positive aspects of clients and their situations, rather than their problems and deficits. It helps clients identify and mobilize their own resources, skills, and abilities to cope with challenges and achieve their desired outcomes. The case manager acts as a facilitator, supporter, and advocate for the client, rather than a provider or expert. The strengths-based model fosters client empowerment, self-determination, and resilience.

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Dr. Brenda Merriweather, DNP, RN

Multi-Award-Winning Healthcare Professional
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I use a model that I created, called, The PAST Model, or Proactive and Aggressive Sickle Cell Disease Treatment Model. The model is for chronic diseases, self-care, patient advocacy, education, preventative care, specialty care, and discharge planning.

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2 Integrated model

The integrated model of case management combines the functions of assessment, planning, service coordination, monitoring, and evaluation into a single role. The case manager works with the client and other service providers to develop and implement a comprehensive and individualized service plan that addresses the client's needs and goals. The integrated model reduces fragmentation, duplication, and gaps in service delivery, and improves communication and collaboration among stakeholders. The integrated model is suitable for clients with complex and multiple needs that require intensive and ongoing support.

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Kristin Stanley, MSN, RN

IDD RN Care Manager
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This is the model I use in my every day work as an RN CM that works with intellectually & developmentally disabled Medicaid members. Care management & goal setting are member-driven, focusing on achievable steps that empowers members and their caregivers to ensure that the member's medical, emotional, functional, and social needs are being met. To do this requires collaboration between the interdisciplinary team including vendors, providers, and other stakeholders. It involves actively listening to the member/caregiver, providing culturally sensitive education, and collaboration. Sometimes it requires creative thinking!

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Janitha Morris

Educator Baltimore County Public Schools
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I have found this model to be very effective, it offers the opportunity to have team support and perspective toward a positive outlook for the client.

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3 Brokerage model

The brokerage model of case management involves linking clients to appropriate and available services and resources in the community. The case manager conducts an initial assessment of the client's needs and preferences, and then refers them to the most suitable service providers. The case manager does not provide direct services or follow-up with the client, but may monitor the quality and effectiveness of the services delivered. The brokerage model is appropriate for clients with relatively simple and short-term needs that can be met by existing services.

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4 Critical time intervention model

The critical time intervention model of case management targets clients who are undergoing a critical transition or crisis in their lives, such as homelessness, hospitalization, or incarceration. The case manager provides intensive and time-limited support to help the client stabilize, connect to services and supports, and build coping skills. The case manager gradually reduces the frequency and intensity of contact as the client becomes more independent and self-reliant. The critical time intervention model aims to prevent relapse, recurrence, or deterioration of the client's situation.

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5 Collaborative care model

The collaborative care model of case management is designed for clients with co-occurring mental and physical health conditions. The case manager works as part of a multidisciplinary team that includes primary care providers, mental health specialists, and other relevant professionals. The case manager coordinates the care of the client across different settings and sectors, and ensures that the client receives evidence-based and integrated treatment. The case manager also provides education, support, and self-management strategies to the client and their family. The collaborative care model improves the quality and outcomes of care for clients with complex and chronic health needs.

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Jan Jones-Schenk

Keynote Speaker, CBE Evangelist, Passionate Believer, Strategic Dreamer, Collaborative Maker, Executive Dean Emeritus, 2022 NLN Presidents Award recipient
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Agree. It is important to do thoughtful team design. Primary care is essential but so is expertise in behavioral health, care coordination, community culture and SDOH. We shouldn’t assume that a physician must ‘lead’ the team. This is like Uber personal-project management. So assemble the best team and be open to how the team is organized and deployed. The ‘leader’ might not necessarily be a physician or nurse!

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Eric Weaver, DHA, MHA

Value-Based Care | Population Health | Health Equity
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A multidisciplinary Collaborative Care Model can deliver integrated care for more complex patient behavioral health needs. When implementing these types of programs, we focused on adding two key services in the primary care setting: care management support for patients receiving behavioral health treatment and regular psychiatric inter-specialty consultation to the primary care team. To be successful, it is imperative that you have physician champions and C-Suite buy-in for this stepped up model of care. In my experience, I've also found it important to have structural measures like program enrollment and caseload size to assess the performance of the integrated behavioral health model. SDOH screening during intake is also critical.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Mary Worth

RN manager experienced in managed care, chronic disease management,transitional care and accountable care organizations.
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You must always assess the client before any other actions or determining what “model” you wish to call your interventions. Personally case management is a process not a “model”. If at all possible an in person meeting gives you so much information before you even start asking questions. Are they able to ambulate? Do they need assistive devices? Are they on oxygen? How does their body look? Adequate nutrition? Did someone bring them or do they drive? Are their clothes clean and hair brushed or do they need help with ADLs? If you aren’t doing a thorough job on initial assessment you are not effective. You make your job harder and give less value to the client.

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Ivan Chew

A Type 9/Si/ESFP Community Social Worker and Connector with 17 years of experience journeying with youths, seniors, caregivers and families in the community social-health sector
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In Singapore, many of us use the PADI model for case management as well as social work supervision: Problem Definition, Attempted Solutions, Desired Outcomes, Intervention. Thanks to this contribution from the late Anthony Yeo, fondly known as the father of Singapore counselling, it has helped us to have a pragmatic approach in the context of social work case mgmt and counselling

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Sheena Jackson

Special Education Teacher
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The Collaborative Problem-Solving (CPS) model is an effective case management approach for special education teachers. It involves building rapport with students and families, incorporating multiple perspectives, setting SMART goals, promoting proactive problem-solving, and fostering collaboration. By implementing CPS, special education teachers can support students in achieving their full potential.

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What are the most effective case management models you've used?

1

2

3

4

5

6

1 Strengths-based model

2 Integrated model

3 Brokerage model

4 Critical time intervention model

5 Collaborative care model

6 Here’s what else to consider

Case Management

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What are the most effective case management models you've used?

1

2

3

4

5

6

1 Strengths-based model

2 Integrated model

3 Brokerage model

4 Critical time intervention model

5 Collaborative care model

6 Here’s what else to consider

Case Management

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