Delphi Approach to explore ways to optimize case manager services in inpatient wards of Sanglah General Hospital
DOI:
https://doi.org/10.53638/phpma.2020.v8.i2.p11Keywords:
Case manager, case management implementation, person-centered care, delphiAbstract
Background and purpose: Case manager services in inpatientrooms have gained popularity in many hospitals in Indonesia,however there are challenges in its implementation. This study aims to explore ways to optimize the characteristics of the case manager, case management practice and outcome of the case manager in
cases in inpatient wards based on the Sanglah Hospital standards.
Methods: The study utilized a two-stage Delphi study design,started with a qualitative data collection and followed by aquantitative survey. Data collection was done in May-June 2020 based on the concept of case manager characteristics, practice and outcomes. The qualitative data collection through in-depth interviews involved 9 key informants. It aimed to explore case manager services based on qualifications, competencies, ethical standards, workload, hierarchy and guidelines, implementation of case management and indicators of effectiveness of case management at Sanglah General Hospital. The results of the indepth interviews with thematic analysis informed the Delphi survey instrument development. The Delphi survey aimed to generate agreement on the characteristic of the case manager, case management practice and outcome of the case manager among 21 expert panelists (case managers) in the inpatient wards of Sanglah Hospital. This Delphi survey was conducted in 3 rounds, the results were analyzed based on the median value and quartile deviation (QD).
Results: The three rounds of the Delphi survey showed that there was an agreement regarding the qualifications of the case manager, competency development, mechanism for appointment and placement of case managers, case manager guidelines, organizational structure, job descriptions and authorities, information of the presence and role of case managers, screening indicators according to characteristics of inpatient cases, case management target measurement tools, case manager service evaluation indicators as well as the activity feedback loop.
Conclusion: Optimization of the case manager service should focus on aspects of human resources, developing guidelines and work systems as well as evaluation indicators and feedback mechanism.
References
Norenzayan A. The eight principles of patient centeredcare. [Internet]. 2019 (cited 2019 Jun 10). Available from: https://www.oneviewhealthcare.com/the-eight-principlesof-patient-centered-care/ doi. 10.2307/j.ctt32bbp0.5
Case Management Society of America. Standards of practise for case management. [Internet]. 2016 (cited 2020 Jun 17);53(9). Available from: https://www.cmsa.org.
Bambang W, Untung S, Pranawa, Supriyatno B, Purjanto, Kuntjoro A, et al. Standar nasional akreditasi rumah sakit [The national standard of hospital accreditation]. 2017;1:57
Health Improvement Network South London. What is person-centred care and why is it important? [Internet]. 2014 (cited 2019 Jun 10). Available from:https://healthinnovationnetwork.com/wpcontent/uploads/2016/07/What_is_person-centred_care
Sutoto. Panduan praktik manajer pelayanan pasien-MPP di rumah sakit (Case Manager) [Guidelines of case manager practices at a hospital]. Hospital Accreditation Committee. 2016;2:1-30.
Cosejo BD. Case Manager – The new emerging healthcare frontliners. [Internet]. 2019 (cited 2020 May 12):2-8. Available from: https://rnspeak.com/case-manager-nurse/
Bragg L, Jennings T. How to optimize your hospital case management model? Navig Revenue Cycle Advis [Internet]. 2017 (cited 209 Nov 22). Available from: http://xue.youdao.com/biarticle.aarticleId=-6915261734181966385&keyfrom=deskdict&date=2014-05-09
Kriegel J, Jehle F, Dieck M, Tuttle-Weidinger L. Optimizing patient flow in Austrian hospitals – Improvement of patient centered care by coordinating hospital-wide patient trails. Int J Healthc Manag. 2015;8(2):89–99.
Woodward J, Rice E. Case management. Nurs Clin North Am. 2015;50(1):109–121.
Van Der Plas AGM, Onwuteaka-Philipsen BD, Van De Watering M, Jansen WJJ, Vissers KC, Deliens L. What is casemanagement in palliative care? An expert panel study. BMC Health Serv Res. 2012;12(1):6–13.
Wardhana A, Rahayu S, Triguno A. Implementasi clinical pathway tahun 2018 dalam upaya meningkatkan mutu pelayanan di Rumah Sakit Umum Daerah Koja [Implementation of 2018 clinical pathway in efforts to increase the quality of service in the Koja Regional General Hospital]. Majalah Sainstekes. 2019;6(1):45–53.
Mutiarasari D, Pinzon RT, Gunadi. Evaluasi proses pengembangan dan penerapan clinical pathway kasus stroke iskemik akut di Rumah Sakit Anutapura Kota Palu. Berkala Ilmiah Kedokteran Duta Wacana. 2017;(April):335–347.
Avia I, Handiyani H. Analisis kompetensi case manager pada rumah sakit di Jakarta: Studi Kasus. Jurnal Perawat Indonesia. 2019;3(1):16–27.
Case Management Society. Case management framework. United Kingdom; 2016: 10-26
Miodonski K. The role of case managers in controlling hospital costs. Fierce Healthcare;2011:p1-3
Walker K, Allen J, Andrews R. Optimizing quality, service, and cost through innovation. Nursing Administration Quarterly. 2011;35(1):68–71.
Ab Latif R, Dahlan A, Ab Mulud Z, Mat Nor MZ. The Delphi technique as a method to obtain consensus in health care education research. Education in Medical Journal. 2017;9(3):89–102.
California Healthcare Foundation. Complex care management toolkit introduction. California;2012:1-14
Belim C, Vaz De Almeida C. Communication competences are the key! A model of communication for the health professional to optimize the health literacy – assertiveness, clear language and positivity. Journal of Healthcare Communication. 2018;3(3):31.
Lega F, Prenestini A, Spurgeon P. Is management essential to improving the performance and sustainability of health care systems and organizations? A systematic review and a roadmap for future studies. Value Heal. 2013;16(1 SUPPL.):46–51.
Treiger TM, Fink-Samnick E. Collaborate©: A universal competency-based paradigm for professional case management, Part I: Introduction, historical validation, and competency presentation. Prof Case Manag. 2013;18(3):122–135.
Corvol A, Moutel G, Somme D. What ethics for case managers? Literature review and discussion. Nursing Ethics. 2016;23(7):729–742.
Kathleen F. The Ethical case manager making a difference ethical principles of case management enhanced nurse licensure compact. [Internet]. 2019;2018–20. Available from: https://www.cmsatoday.com/2018/08/28/theethicalcase-manager-making-a-difference/
Yuliati NK, Nopiyani NMS, Duarsa DP. The roles of case managers and problems encountered in implementing patient centered care in hospitals. Public Health and Preventive Medicine Archive (PHPMA).2019;7(2):140–147.
Lukersmith S, Millington M, Salvador-carulla L. What is case management ? A scoping and mapping review. International Journal of Integrated Care. 2016;16(4):1–13.
Aeni WN. Pengembangan case manager dalam patientcentered care [Case manager development in patientcentered care]. Jurnal Manajemen Keperawatan. 2014;2(2):126-134
Avia I, Handiyani H, Nurdiana N. Analisis kompetensi case manager pada rumah sakit di Jakarta: Studi Kasus [Analysis of case manager competencies at hospitals in Jakarta]. Jurnal Perawat Indonesia. 2019;3(1):16.
Health Quality Ontario R. Experiencing integrated care [Internet]. 2015. Available from: https://www.hqontario.ca/Portals/0/documents/pr/report-experiencing-integratedcare-1504-en.pdf.
Chase L. Nurse manager competencies (Thesis). Iowa Research Online.1994;24(4S):56–64.
Tahan HM. Essentials of advocacy in case management: Part 1: Ethical underpinnings of advocacy - Theories, principles, and concepts. Professional Case Management. 2016;21(4):163–179.
Anne L. Managed healthcare matters - Key competencies for professional case [Internet]. 2018:1-18. Available from: https://www.psninc.net/blog/key-competencies-forprofessional-case-managers-how-are-your-metrics
Rossi PA. The hospital case management orientation manual: HCPro publishing; 2014; 1-39
Fraser KD, Garland BL, Labonte S, O’Rourke H, Punjani NS. Case manager work and workload: Uncovering a wicked problem—A secondary analysis using interpretive description. Home Health Care Management Practice Journal. 2019;31(2):83–91.
Jubelt LE, Graham J, Maeng DD, Li H, Epstein AJ, Metlay JP. Patient ratings of case managers in a medical home: Associations with patient satisfaction and health care utilization. Annals of Internal Medicine. 2014;161(10):59–65.
Atmaja BP, Afiyanti Y, Yuliani B. Pelaksanaan case management oleh kepala ruang di RSUD Banjarmasin [Implementation of case management by head of wards at Banjarmasin District Hospital]. Jurnal Darul Azhar. 2018;5(1):8-16.
Joo JY, Huber DL. Scoping review of nursing case management in the United States. Clin Nurs Res.2018;27(8):1002–1016.
Sihura SSG, Yetti K, Herawati R. Implementation of nursing rounds and discharge planning in Fatmawati Hospital Jakarta. International Journal of Nursing and Health Services. 2019;2(1):117–127.
Murray L, DeNatris P. Case management practice guide-7 phases of case management. [Internet]. 2010 (cited 2019 Sep 25); (March):25. Available from:http://www.abistafftraining.info/pdf/case_management_practice_guide_7_phases_march2010.pdf
Family & Community Service. Case management includes elements of case management, changes as a result of keep them safe and case management in operation [Internet]. 2020 (cited 2020 Jun 15);1–18. Available from:https://www.facs.nsw.gov.au/providers/childrenfamilies/interagencyguidelines/casemanagement/chapters/element
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