Care Management and Case Management

Paper Summary:

This essay states that the greatest challenges in the healthcare system currently consist of controlling costs, improving clinical outcomes, and ensuring quality care. Barriers to those goals include the nursing shortage, a rapidly aging population, competition, and reduced government reimbursement. This article addresses the most problematic issues in healthcare today but offers direction for their solutions rather than facile solutions. The paper goes on to claim that the overwhelming question for the current healthcare system presently concerns how to improve quality while reducing costs. Case management and care management are two valuable strategies which can control costs while improving clinical outcomes and ensuring quality care.

Outline:
Introduction
Rationale
Case Management vs. Care Management
Attempts for Quality
Journal Selected for Submission

From the Paper:

"The current nursing shortage appears to be intractable. Recent government downsizing and cutbacks have been followed by reduced funding for the healthcare system that is about to be overwhelmed by the baby boom generation. Never have there been so many obstacles to cost-effective, quality care. Two choices are available: case management and care management, with the latter actually being the common alternative. High-risk patients need individual case management but the vast majority of patients require some form of care management (Doyle et al., 2003). Care management is evidence-based practice since such practice is an essential element in clinical pathways and protocols. Even though standard pathways are used, stringent pathways are being eliminated since evidence-based protocols and guidelines are becoming the norm."

Sample of Sources Used:

• Adams, C.E. & Wilson, M. (1995). Enhanced quality through outcome-focused standardized care plans. Issues in Nursing in Canada. Charles Sturt University.
• Canadian Nurses Association (CNA) (2007). Canadian Nurse vision and mission. http://www.canadian-nurse.com
• Cummings, G. (2003). Quality of care. In J.C. Ross-Kerr & M. J. Wood (Eds.). Canadian nursing (pp. 177-194). Toronto: Mosby.
• Doyle, B., Vallejo, B.C., Horgan, M., & Foust, J.B. (2003). Care management and case management. In E.L. Siegler, S. Mirafzali, & J.B. Foust (Eds.). An introduction to hospitals and inpatient care (pp. 171-183). New York: Springer Publishing.
• Landesman, A. (1996). Restructuring hospitals, restructuring nursing. Issues in Nursing in Canada. Charles Sturt University.

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