• Vol. 31 No. 4, 461–466
  • 15 July 2002

Causes for the Evolution of Case Management and the Development of a Working Model in an Acute Care Hospital in Singapore

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ABSTRACT

Case management is a collaborative process which assesses, plans, implements, co-ordinates, monitors and evaluates options and services to meet an individual’s health needs. The case manager performs a key role in ensuring that collaboration and communication between the multi-disciplinary healthcare team and patient is maintained, and that quality clinical outcomes are achieved and the patients reach an optimal level of wellness and function. Patients that can benefit from case management in an acute hospital setting are frequently elderly and have complex medical and care issues arising out of changes in functional status. The components of a successful case management system include identifying a suitable model for implementation and recruiting the correct persons to function as case managers. A defined assessment and recruitment guideline will ensure that appropriate patients are placed on case management. Communication and collaboration with all stakeholders in formulating a patient’s plan of care are essential. The subsequent implementation and monitoring of the plan is crucial, as variances that occur must be adequately managed in order to ensure that a satisfactory clinical outcome is achieved without inappropriate expenditure of resources. The barriers to a successful case management programme can result from inappropriate case loads and failure of the other healthcare team members to understand and appreciate the case manager’s role and functions. However, this can be overcome by education and using outcome data to demonstrate the effectiveness of case management.


In 1999, significant changes to the healthcare funding structure were introduced to public sector hospitals in Singapore. This was the advent of casemix-based funding for acute inpatient and day surgery episodes.

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