Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program.
Defining case management success: a qualitative study of case manager perspectives from a large-scale health and social needs support program.
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DOI：
10.1136/bmjoq-2021-001807
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发表时间：
2022-06
期刊：
影响因子：
1.4
通讯作者：
Brewster, Amanda L.
中科院分区：
文献类型：
--
作者：
Knox, Margae;Esteban, Emily E.;Hernandez, Elizabeth A.;Fleming, Mark D.;Safaeinilli, Nadia;Brewster, Amanda L.
卫生系统正在扩大努力，以解决健康和社会风险，尽管早期证据的异质性表明，需要更细致入微地探索这些计划如何运作，以及如何全面评估计划的成功。本质性研究旨在从跨学科个案管理者的角度，确定大规模、健康和社会需求个案管理计划的成功特征。由一个综合的、以县为基础的公共卫生系统管理的高风险、复杂病人的病例管理计划。70名个案经理中的30名，有目的地抽样代表他们的跨学科健康和社会工作背景。面试于2019年3月至11月进行。该分析旨在确定成功与患者合作的特征。病例管理者描述了与患者成功合作的三个特征：（1）建立信任;（2）观察患者心态或主动性的变化;（3）促进稳定和独立。贯穿这些特征，病例管理者强调患者定义自己成功的重要性，通常通过个性化，渐进式进展来证明。因此，成功的时刻通常与外部感知和运营或生产力指标形成对比。主题强调同情患者生活复杂性的重要性，以及建立在纵向关系上的循序渐进的成功过程。
Health systems are expanding efforts to address health and social risks, although the heterogeneity of early evidence indicates need for more nuanced exploration of how such programs work and how to holistically assess program success. This qualitative study aims to identify characteristics of success in a large-scale, health and social needs case management program from the perspective of interdisciplinary case managers. Case management program for high-risk, complex patients run by an integrated, county-based public health system. 30 out of 70 case managers, purposively sampled to represent their interdisciplinary health and social work backgrounds. Interviews took place in March–November 2019. The analysis intended to identify characteristics of success working with patients. Case managers described three characteristics of success working with patients: (1) establishing trust; (2) observing change in patients’ mindset or initiative and (3) promoting stability and independence. Cross-cutting these characteristics, case managers emphasised the importance of patients defining their own success, often demonstrated through individualised, incremental progress. Thus, moments of success commonly contrasted with external perceptions and operational or productivity metrics. Themes emphasise the importance of compassion for complexity in patients’ lives, and success as a step-by-step process that is built over longitudinal relationships.
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DOI：
10.1503/cmaj.210229
发表时间：
2021-11-08
期刊：
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
影响因子：
--
作者：
Bloch G;Rozmovits L
通讯作者：
Rozmovits L
影响因子：
158.5
作者：
Finkelstein, Amy;Zhou, Annetta;Doyle, Joseph
通讯作者：
Doyle, Joseph
影响因子：
4.4
作者：
Chan, Brian;Hulen, Elizabeth;Saha, Somnath
通讯作者：
Saha, Somnath
影响因子：
3.5
作者：
Komaromy, Miriam;Madden, Erin Fanning;Arora, Sanjeev
通讯作者：
Arora, Sanjeev
影响因子：
3.6
作者：
O'Brien, Colin W.;Breland, Jessica Y.;Zulman, Donna M.
通讯作者：
Zulman, Donna M.