There is no denying that modern health care can be a complicated web of red tape, bureaucracy, and long waits. A certain level of familiarity with the health care and community service industry is a prerequisite to navigating the landscape and obtaining the level of care that is required.
In fact, these bureaucratic speed bumps can be a barrier to even those familiar with the system. Imagine the difficulty that a client or their family may encounter if they are not able to see a situation for what it is or lack the knowledge and education to make an informed decision. The frustration would be unimaginable and the consequences, potentially, quite severe.
These situations have given rise to a role in health and community services that seeks to act as an intermediary on behalf of the client and their family as they interact with the health and community service industry. These essential and highly valued individuals are case managers.
What is the role of case management in health care?
Case management in the health and community services industry involves a case manager assessing the information available to a client and distilling that often complex information set down into easily understandable bits of information. Case managers also act as advocates for clients and their families as they work through complicated decisions of tremendous impact.
Case management is a collaborative effort that often involves a team of trained professionals working in concert with a case manager to assess a client’s health situations, determine the best path forward to meet the client’s goals, and working with the client and their family to determine the best financial option.
Why is it important to have a good case management process in community services?
An effective case management process is essential for health and community services for a couple of reasons. First, the clients that health service case managers work with are of those in society who need help the most. These individuals, due to their background, socio-economic status, or their current health needs are typically not equipped or capable of fully understanding their options and their implications. These clients need an advocate who can translate the verbose and, frankly, confusing medical landscape.
Second, good case management is essential because no two client situations are the same. Each person brings their individual needs, goals, and resources to their specific situation and it takes a skilled community service case manager to accurately assess the situation and help a client in the way they need it most.
Third, solutions don’t often come quickly for these clients. Plans to achieve their goals often stretch into months or even years. Over time, details can be forgotten and the measured aspects of goals can be overlooked. A quality case management process in place ensures that these important details aren’t overlooked. As with most projects, the organization on the front end sets up success in the end.
The four levels of case management
The fundamental levels of effective case management can be broken out into four distinct categories: intake, needs assessment, service planning, and monitoring and evaluating. Case managers are responsible for overseeing each level carefully as each level builds on the previous.
Intake: The first level of case management involves the assigned health care social worker gathering as much demographic information, specifics about any immediate needs the client might have, and establishing a relationship with the client and their family.
Needs assessment: Building off of the initial information gathering level, case managers then move to assess the specific needs of the client. Here they will work with the client to develop a list of key problems, needs, and interests and then establish specific and measurable goals around them. The case manager will also communicate realistic challenges that may be encountered during the process to ensure that everyone is on the same page.
Service planning: This third level is likely the most time-intensive portion of the health case management service process. Specific actions are outlined to achieve the client’s goals as well as a realistic timeline for completion. Most importantly, specific metrics are set to assess progress.
Monitoring and evaluating: In the fourth step of case management, case managers will use the agreed up metrics to monitor progress. It is critical that case managers use objective data to assess progress and not anecdotal evidence. This level can be revisited as service plans and needs change over time.
What is the role of a case manager in a health care organization?
Case managers are tasked with coordinating the collaborative efforts aimed toward the rehabilitation of a client. Case managers are skilled at juggling a variety of priorities simultaneously to ensure that the best and most appropriate medical care is administered. This role requires exceptional planning and organization to be successful.
The health care social worker
Social workers in the community service field are responsible for helping clients achieve their social and personal life goals. These professionals advocate for their clients to make sure they are integrated into social and personal environments with the opportunities they are fully entitled to. Health care social workers are also responsible for ensuring that their clients are safe and secure in their environments. Much like case managers, this role requires a high degree of organization and planning.
What is a human service organization?
Much work is required in the filed of human services and to accomplish this work, organizations that specialize in specific fields have flourished over the past decades. Broadly, human service organizations work for the better of the individual and society. These organizations often focus on very specific needs that they identify and have the resources to address. Human service organizations can be broadly broken down into three categories: non-profit organizations, government organizations, and private sector organizations.
Non-profit organizations: Non-profit organizations are tax-exempt and not driven by a profit motive. As these organizations aren’t concerned with profits, their primary source of funding is from donations and grants. These funds are secured on the strength of the organization’s track record of success, their plans for the funding, and their financial solvency. As a result, non-profits are beholden to their funders and responsible for reporting back to them on how their funds were used. Non-profits typically focus in on very specific needs such as feeding lower-income children or providing health care services to the homeless population.
Private sector organizations: Human service organizations that exist in the private sector are not beholden to the sometimes stringent expectations of funders because these organizations do work toward a profit. This change in the financial model frees the private sector up to be a bit more independent in their approach to services.
Governmental organizations: The largest piece of the human service organization pie is dominated by public or government organizations. Where non-profit organizations are dependent upon individual funders and grants and private sector organizations require a profit to sustain themselves, public organizations such as the Department for Health and Human Services and The Department of Housing and Urban Development are backed by the funding of Federal and state governments. Due to ample funding and broad charges, these organizations are able to accomplish a great deal of good in society.
What is the role of a human service worker?
Human service workers are trained, certified individuals who work to meet human needs and improve their client’s lives. These individuals help clients navigate addiction, family violence, alcoholism, intellectual disabilities, and many, many more situations. These individuals often find themselves working outside of an office environment and rather end up in residential settings with their clients.
At the end of the day, these professionals are driven to help others. Additionally, they must be in command of a diverse knowledge base. The understanding of how socio-economic factors, the culture in which they operate, and human development affect their clients is essential.
Human service work is a difficult yet rewarding occupation. These individuals must possess a wide range of skills to accomplish their goals. Some of these attributes include:
Empathy: This is perhaps the single most important attribute that human service workers must possess. Being able to understand a client’s situation and taking into consideration their socioeconomic status, cultural background, and the symptoms of their condition are invaluable and can quickly determine how successful a case will turn out to be.
Consummate organization: The work of a human service worker is multifaceted and requires consummate organization. Beyond the core responsibilities of working one-on-one with a client and their family, human service workers are also responsible for billing, advocating on behalf of their client to the medical community, and sharing information with other organizations who are helping the client. Keeping contact information, billing hours, and case notes organized is an essential function.
Exceptional communication: Human service workers are called upon to communicate a variety of issues in both written and verbal form. Not only that, but these professionals must also communicate with an extremely diverse group of stakeholders. Clients expect realistic and honest communication about their goals and the likelihood of achieving them. Their families expect the same. Communicating with medical professionals requires a high degree of understanding and the ability to translate those concepts into bite-sized chunks for the client.
Active listening: Being able to listen attentively and seeking clarification goes hand in hadn’t with effective communication. The only way to have a true understanding of the client’s needs and prospective goals is to be a great listener.
Resilience: Human service work is tiring and requires a lot of patience. Results don’t also come as quickly as the caseworker or the client and their family may like. The ability to keep trying and adjust course goes a long way in this line of work.
Tolerance: A healthy respect for individuals of different cultures, backgrounds, economic backgrounds, religious affiliations, and ethnicities is a must for human service workers. A lack of tolerance is most certainly a barrier to entry for this career path.
Planning: Great planning is where the communication and organization pieces meet. Once a clear understanding of the client’s situation and goals has been established, a detailed plan for success must be developed. A great human service worker is able to create an achievable plan that balances specific measurable targets with realistic timelines.
Best case management software for health and community services
The diverse needs of the health and community services sector require a case management software that is efficient, responsive, and flexible. PlanStreet’s case management software excels in being adaptable to the specific needs of an organization.
Virtual workspace: The platform is accessible anywhere, anytime, by anyone. This flexibility allows case managers and health service workers at any level of the organization to check in on a case from the office or in the field.
Organization: All documents, calendars, and tasks can be stored and organized in a single place.
Task management: PlanStreet’s case management software makes assigning and tracking tasks simple. Dependency tasks are easily identified and bottlenecks in the timeline can be eliminated.
Custom reports: Individual case managers and clients have different needs and goals. PlanStreet’s case management system allows for easily customized reports to give case managers the exact set of information they need to be successful.
Additionally, the safety and security of client information should be at the top of the wishlist for any health and community service organization. PlanStreet has gone to great lengths to provide a safe secure platform for health service caseworkers to work with. The web-based software is HIPAA compliant and is updated regularly to address newly emerging threats. More and more health and community service work are moving into cloud-based products and these organizations deserve to operate with the faith that their client information is safe and secure.
PlanStreet has worked hard to provide a product that is as flexible as the case managers are required to be. It is the right tool to take health and community service organizations to the next level of care.