Professional Case Management最新文献

Purpose of study: The purpose is to describe sepsis survivors' functional recovery and symptom experience following Intensive Care Unit (ICU) hospitalization.

Primary practice settings: Academic Medical Center, Community Living.

Methodology and sample: This longitudinal observational study recruited participants during hospitalization at two adult ICUs in a single Midwestern academic medical center. Participants completed surveys to assess function and symptom experience at baseline (discharge), 1-month, 3-months, and 6-months post-discharge.

Results: Participants were non-Hispanic Whites with mean age 55.4 years (SD = 17.0). The majority were discharged to home (78.6%), with 3 (21.4%) discharged to a skilled nursing facility or acute rehabilitation unit. Participants had notable improvements in mobility, self-rated health, and fatigue from discharge to 6-months post-discharge. Increases in mobility from discharge to 1 month, 3 months, and 6 months were statistically significant (α < .05). Decreases in fatigue from discharge to 1 month and 6 months were statistically significant (α < .05). Cognitive and social engagement and other symptom experience measures did not differ significantly during the study period.

Implications for case management practice: Findings reveal trends in mobility recovery and symptom experience post-hospitalization, which are important considerations post-ICU sepsis hospitalization. This study reinforces the need to promote early mobilization of patients during hospitalization and work with patients to develop strategies for mobility recovery post-hospitalization, as part of a comprehensive plan which integrates a client's medical, behavioral, social, psychological, functional, and other needs. The authors encourage assessment of common symptoms, including pain, fatigue, anxiety, and sleep disturbance, experienced by sepsis survivors during and post-hospitalization. As a result, case managers will be better positioned to implement evidence-based interventions to promote recovery and reduce symptom burden and improve outcomes. Evidence-based interventions should include those that are centered on client's functional and symptom-related needs, preferences, safe mobility, and facilitate awareness of and connections with community supports and resources.

Methods: This study used a qualitative descriptive design. Through snowball sampling, community members who have experience with loved ones receiving end-of-life care were recruited by snowball-sampling. The interviews lasted approximately 90 minutes. Two open-ended questions were posed, and participants led the discussion by interpreting the questions in any way they wanted and telling the story they wanted to tell. Interviews were transcribed into Excel, and line-by-line analysis was utilized to group data (answers) into developed themes; themes were then broken down into subthemes. Literature was consulted to understand themes further.

Conclusions: For decades, research has recommended truth and transparency in end-of-life care discussions with patients, families, and family-centered care. This study demonstrated that, in practice, this is often not done, resulting in further traumatization to families at the end of life. Additional research needs to be done to understand this practice gap and recommend strategies to overcome it.

Results: Families experiencing end-of-life care are experiencing extensive acute trauma. The acute stress of this trauma makes information processing and decision-making very difficult. From the discipline of psychology, a person cannot make good decisions when they are experiencing trauma. At end-of-life, person-centered care is family-centered care. A person's individuality is inextricable from who they are to their family. If we do not care for the family, we do not care for our patients.

Purpose and objectives: This paper aims to raise awareness of the case management community about innovative primary care models, like the Making Care Primary (MCP) which has potential to become the foundation for future primary care reform. It provides professional case managers (PCMs), case management leaders, and primary care providers with examples of evidence-based best practices to apply in primary care settings and programs.

Primary practice settings: Primary care practices and organizations, ambulatory clinics, community-based primary care.

Findings/conclusions: The authors share examples of findings from case management research published over the last 10 years as they pertain to the 3 main domains of MCP-care management, care integration, and community connections-to show the impact case management interventions may have on key outcomes in value-based primary care. The systematic, narrative, and scoping reviews summarized in this paper suggest a set of important case management structures, processes and outcomes relevant to care management, care integration, and community connections that help manage the diverse needs of patients. This evidence is also important in identifying essential case management interventions that ensure person-centered and holistic care and improve patient outcomes especially as they pertain to personal health and wellbeing.

Implications for case management practice: The authors of this paper draw attention to the importance of PCMs and their roles in evolving primary care models in the context of teams and effective teamwork. The contributions of PCMs on primary care teams can be extensive and critical to the successful achievement of desirable primary care outcomes for individuals with complex chronic illness and health-related social needs and thus to the overall success of value-based models of primary care. The evidence the authors summarize provide important guidance on best case management practices in primary care that contribute to better health outcomes.

Purpose of study: This study explored the roles, training, and qualifications of case managers in level A of Taiwan's long-term care (LTC) system, established within the Ten-Year LTC Plan 2.0, to identify their challenges and provide recommendations for enhancing their performance.

Primary practice setting: This study focuses on community integrated service centers in Taiwan, which serve as key hubs for delivering LTC services to Taiwan's aging population.

Methodology and sample: A narrative review approach was implemented, with an extensive analysis of the literature in terms of the functions and training requirements of and the professional challenges faced by case managers in the LTC sector. This review included articles published between 2016 and 2024 in both English and Chinese.

Results: Case managers play a key role in linking LTC resources and coordinating care for older clients. However, they often face major challenges, including a high caseload, inadequate training opportunities, and a desire to quit, which adversely affect service quality and outcomes.

Professional case managers (PCMs) play pivotal roles in the evolution of primary care as highlighted by the paper "Preparing for New Primary Care Models: The Role of Professional Case Management." PCMs are influential in value-based primary care and are important members of interprofessional teams striving to achieve key care outcomes such as those emphasized in the Making Care Primary Model.