Reconceptualizing case management in theory and practice: a frontline perspective.

Area of Science:

• Health Services Research
• Social Work Practice
• Healthcare Management

Background:

• Case management in health and social services faces challenges due to conflicting stakeholder agendas and political complexities.
• Existing case management models in Australian long-term care settings were examined for their effectiveness and impact on clients and case managers.

Purpose of the Study:

• To explore the role and experiences of front-line case managers within three evolving Australian long-term care models.
• To identify factors influencing case managers' ability to secure necessary services for clients.
• To propose a reconceptualized approach to case management for improved client care.

Main Methods:

• Qualitative research involving 51 open-ended interviews with front-line case managers.
• Exploration of the impact of case management models on client services and case manager roles.
• Analysis of the interplay between system, model, and client factors influencing service attainment.

Main Results:

• Case management models were found to be predominantly 'system-centered' rather than client-centered, limiting case managers' ability to obtain services.
• Case manager success in securing services depended on their skills, client relationships, job satisfaction, system influence, and collaboration.
• The study identified key influences on case managers' effectiveness in achieving appropriate client services.

Conclusions:

• Current case management models often fail to be client-centered, hindering effective service delivery.
• A proposed 'neo-process-centred' multidimensional approach offers a framework for improving case management.
• The findings have significant implications for policy makers, management, and practitioners aiming to enhance client care.