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Case management: a formula for resource conservation.

S Daniels1, J Sands

  • 1Phoenix Management Group, Pompano Beach, FL, USA.

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
|December 9, 1995
PubMed
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This study presents a practical case management model for acute care hospitals. It integrates quality, risk, and utilization management into a comprehensive quality resource management program, enhancing value for all stakeholders.

Area of Science:

  • Healthcare Administration
  • Hospital Management
  • Quality Improvement

Background:

  • Case management is recognized for enhancing efficiency and effectiveness in acute care settings.
  • Traditional case management often involves siloed functions like quality, risk, and utilization management.
  • Integrating these functions can streamline operations and improve patient care pathways.

Purpose of the Study:

  • To introduce a novel case management model for acute care.
  • To demonstrate the integration of quality, risk, and utilization management under a unified framework.
  • To present a practical approach for organizing case management programs in hospitals.

Main Methods:

  • The study describes a model transforming existing services into value-added functions.

Related Experiment Videos

  • It focuses on integrating nonrevenue-producing activities within a hospital setting.
  • The approach was implemented in an acute care hospital in Florida.

    • Main Results:

    • The integrated model transformed traditional services into value-added components.
    • This approach benefits patients, physicians, hospitals, and payers.
    • A practical framework for organizing case management was established.

    Conclusions:

    • The proposed quality resource management model offers a practical and effective approach to case management in acute care.
    • Integration of key management functions enhances overall hospital value and stakeholder satisfaction.
    • The transformation process, while presenting challenges, yields significant benefits for healthcare delivery.