The hospital case management system is a service designed to provide patients with individualized tailored assistance throughout every phase of their hospital care. Hospital case managers are licensed administrators who are charged with coordinating patient-centric care, from planning to implementation of services, to acting as a liaison on behalf of patients. Primary responsibilities include client advocacy, continual review and assessment of client progress, and management of all available resources needed for patient wellness.
Primary Assessment and Planning
At time of admission, hospital case managers conduct an initial assessment of patients and their individual needs. Depending on the situation, they may also assess the needs of the client’s family and perform a psychological assessment. From there, the case manager will develop a specific plan for care of the patient and then continue to assess the patient's progress throughout their treatment. The goal is to formulate a comprehensive plan of action to help clients reach their goals in regard to their medical care during and after their hospital stay.
From admission to post-discharge, the hospital case manager serves as the patient's advocate. They work directly with administrators, doctors and all other hospital staff to determine the optimal course of care, as well as keep all parties up to date regarding in changes in care. They also communicate with insurance providers to ensure that the services provided to patients are covered at the insurer’s maximum level both during the hospital stay and at home. Not only are case managers a “voice” for their patients, but they also relay much needed information to patients and their families about all aspects of medical care received.
Review and Evaluation
Hospital case managers conduct regular reviews of medical records and evaluate patient services and satisfaction to make sure that appropriate care has been issued from the time of patient's admission through patient’s discharge.
One of the primary duties of a hospital case manager is to aid the patient in transitioning through each level of care. Hospital case managers coordinate the integration of services required for patient care, discharge, and post-discharge home assimilation with various hospital departments, service agencies and healthcare facilities.
Upon a patient's discharge, hospital case managers may also assist patients in setting up care for outside of the hospital setting. This involves gathering referrals for medical assistance at home, equipment rentals or purchases, rehabilitation services and even long-term care facilities.
Again, the goal of a hospital case manager is to provide optimal resources to the patient to facilitate their care and support at every level.