 The Integrated Case Management Manual: Assisting Complex Patients Regain Physical and Mental Health
Roger G. Kathol, Rebecca Perez, & Janice S. Cohen
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here to buy at Springer Publishing Company.
Book Preface
Having provided clinical services to patients at the interface of
general medicine and psychiatry throughout our professional careers,
we have been impressed with the degree to which health issues related
to the mind and body interact. Yet each of us work in systems of
care that rigorously separate and approach physical and mental conditions
as if the mind and body had no connection. The purpose of this Manual
is to share with case managers that the assessment and treatment
of mental health and general medical conditions are more similar
than dissimilar. Segregation of care in these domains and in other
domains that create barriers to health is counterproductive. Rather,
assistance with return to health can be more effectively and efficiently
accomplished when a unified approach is used.
This Manual was written to apply this principle to the practice of
case management, a discipline in which nurses and other health professionals
assist patients/clients (hereafter referred to as patients) with
health complexity overcome barriers to improvement. Case managers
were chosen as the target audience for this Manual because they primarily
and routinely work with patients who have multiple poorly controlled
health conditions, a high percentage of which involves both general
medical and mental health issues and/or social and health system
challenges. Their patients are also the ones who use a high percentage
of health resources. Thus, if improved support for their care can
be achieved through the systematic application of complexity measurement
and an "integrated" approach to breaking down complexity-based
barriers, it is reasoned that case managers can become major contributors
to better health and total health-related cost reduction as care
delivery and payment reform measures are introduced.
We consider this Manual an introduction to the next generation of
case management, integrated case management. Unlike traditional case
management, it guides case managers with either medical or mental
health backgrounds as they develop skills that will allow them to
connect and assist with health issues in the biological, psychological,
social, and health system domains while maintaining a personal relationship
with the patient. Patient handoffs are the exception and follow through
on care manager assistance over time is the rule.
Integrated case management does this by linking health complexity
assessments to integrated assistance techniques. Based on level of
complexity, case managers prioritize associated barriers to improvement
in various domains, build care plans, and assist patients as they
stabilize and/or return to health. Core components in the integrated
case management process include: a relationship and communication
between complex patients and the case manager, a longitudinal outcomes
orientation, the systematic assessment of complexity, use of complexity
item scores and their interactions to guide health improvement actions,
and case manager accountability for health outcomes in all risk and
needs domains. In essence, it transforms traditional case management
into an approach that systematizes assessments, connects evaluation
findings to multi-domain actions, and moves managed patients toward
documentable improvement and graduation.
Case managers studying this Manual will develop new and important
cross-disciplinary skills, which will allow them to alter the health
trajectory of some of the most needy patients in the health system.
Cartesian Solutions, Inc.™
3004 Foxpoint Rd. - Burnsville, MN 55337
Phone: 952-426-1626 - Fax: 952-426-1200
E-mail: integration@cartesiansolutions.com
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