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Preparing health care organizations for successful case management programs
C A Bonvissuto1, J M Kastens, S R Atwell
1Marketing Department, Chi Systems, Inc., Ann Arbor, MI 48104, USA.
Journal of Case Management
|July 1, 1997
Summary
Implementing hospital case management programs requires centralized functions, clear targets, and a communication plan for success in managed care. This study highlights key elements for effective healthcare delivery and patient outcomes.
Area of Science:
- Healthcare Management
- Health Services Research
- Quality Improvement
Background:
- Hospital case management programs are crucial for navigating managed care.
- Successful implementation requires specific organizational elements.
- Providers face challenges with reimbursement and quality demands.
Purpose of the Study:
- To evaluate the implementation status of case management programs in four hospitals.
- To identify critical success factors and challenges in case management implementation.
- To provide recommendations for healthcare organizations implementing case management.
Main Methods:
- Study of four hospital-based providers at different stages of case management implementation.
- Analysis of existing organizational structures, information systems, and quality improvement initiatives.
- Qualitative assessment of program elements and success factors.
Main Results:
- Three of the four providers had essential elements for success in place.
- Key success factors included diverse reimbursement, integrated information systems, comprehensive services, and quality programs.
- Varying stages of implementation were observed across the studied providers.
Conclusions:
- Centralizing case management functions is recommended for effective program structure.
- Setting realistic, quantifiable targets is essential for monitoring progress.
- A robust communications plan is vital for program adoption and success.