Research directions for case management.

Case management is a worldwide phenomenon and depending on the particular country's organizational framework of the health and social system, many models have been developed. The definitions of case management vary, but all of the models being developed aim to provide holistic quality care that is cost-effective. Reviewing the various components of case management is important because they contribute to the success or failure of providing quality, cost-effective care. The geographical setting where case managers work (i.e., hospitals or community/home), and the level of fiscal authority given to the case managers are two important components of case management models. Whether there is a conflict between case managers acting as advocates of clients while at the same time being the gatekeeper of funds is an area that needs exploration. The question is can the two notions be "married" as opposed to being inherently conflicting, and can case managers act in the best interests of the clients. There are many research directions for case management, including which aspects of the model ultimately have positive results for the client and health and social system.

Embracing the continuum of care: an Australian private hospital's experience.

Continuity of care throughout the home, community, and hospital settings is essential in providing quality health care. A continuum-of-care model assists in improving communication between all stakeholders, decreases confusion, and ensures appropriate provision of resources so that patient/client care needs are met. Historically, continuity of care has been difficult to provide because care delivery has taken place in separate settings. In addition, appropriate processes, incentives and resources have not been in place to ensure sufficient interaction between care providers. In Australia the concept of case management has been inviting because it acknowledges the importance of continuity of care. It also addresses pressures on the health care system to ensure quality, cost-effective service provision. The extent to which continuity of care is provided depends on the flexibility of the case management model including the flexibility of care providers to interact between settings. This article presents an Australian private hospital's experience utilizing a case management model. Three specialties (Home Care, Oncology, and Medical) will be used as examples demonstrating how the model incorporates the continuum of care concept. Their challenges in providing continuity of care beyond the hospital walls are explored.

Case management at Warringal Private Hospital: challenges of development, implementation and evaluation.

Case management has the potential to improve the quality of care for patients, streamline efficiencies within organisations, and ultimately lower health care expenditure. This article explores why Warringal Private Hospital embraced the concept and how the chosen model of case management was developed. It describes the implementation and evaluation of the model and how it was received, accepted, and applied by the various stakeholders. The cardiac and orthopaedic units will be cited as case studies in order to emphasise some of the challenges encountered in this process as well as the successful outcomes. It should be noted, however, that each unit within the hospital is unique and, although the principles of case management have been applied throughout the hospital, the development, implementation and evaluation has been specific to each unit.