Background:
Care management roles and responsibilities are frequently called out in leading white papers and exemplars; yet, the actual roles and responsibilities are poorly defined.
Method:
A qualitative content analysis using 6 landmark white papers and exemplars from national organizations to collect emerging care management and coordination roles and responsibilities.
Results:
Three major themes emerged from the content analysis: (1) care management is about complex systems and complex medical and social needs, (2) nurses are central to the interdisciplinary team, and (3) informatics is vital to support and enhance care management.
Implications for Practice:
Care managers need to be experienced with complex systems of care as well as complex diagnoses and conditions that our clients and their caregiver's experience. A nurse being central to the clients and embedded within the interdisciplinary team aids in diminishing the burden of negotiating the trajectory of a condition/illness as well as improves the interdisciplinary communication and teamwork. This review of literature has defined the complexity of care management and the discreet roles and responsibilities, as well as how informatics is vital for care managers to target and monitor key populations needing care management.
To create or expand care management processes to meet the goals of health care reform, systems first need to know what care managers/coordinators are doing and where their current focus on care presides. Educators, leaders, and, indeed, the care managers themselves are a part of preparing this dynamic workforce. The major responsibility of care management continues to be direct patient interactions, meaning that care managers are performing vital interpersonal patient interaction needed to achieve highly personalized patient care with assurances of quality and safety. No matter the name-care management, case management, or care coordination-these activities are an essential part of health care, with highly specialized skills that promote patient engagement and activation.
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