Another look at roles and functions: has hospital case management lost its way?
OBJECTIVE
The purpose of this study was to identify the roles, functions, and types of activities that hospital case managers engage in on a day-to-day basis and that leverage the most amounts of time. Previous studies superimpose a priori categories on research tools.


METHODS
Hospital case management.


METHODS
This study analyzes 4,064 spontaneous, unstructured list serve postings from the American Case Management Association Learning Link list serve from August 15, 2011, to August 18, 2012. The study group was a cross section of 415 case management professionals.


CONCLUSIONS
The data suggest that hospital case managers' time is inordinately leveraged by issues related to observation status/leveling of patients and the Centers for Medicare and Medicaid Services compliance. The data also suggest that hospital case management has taken a conceptual trajectory that has deviated significantly from what was initially conceived (quality, advocacy, and care coordination) and what is publicly purported. Case management education and practical orientation will need to be commensurate with this emerging emphasis. Case management leadership will need to be adept at mitigating the stresses of role confusion, role conflict, and role ambiguity.
Care Management & Patient Access, Saint Vincent’s Medical Center, 47 Long Lots Rd., Westport, CT 06880, USA. jrccm@optonline.net
John J
JJ
Reynolds
D019090:Case Management; D014487:Centers for Medicare and Medicaid Services, U.S.; D004496:Education, Continuing; D006739:Hospital Administration; D024382:Professional Role; D014481:United States