Case Management Concepts, Models, and Principles
Core concepts
Case management is a collaborative, patient-centered process that includes screening, assessment, planning, implementation, coordination, monitoring, and evaluation. It is not the same as utilization review (a component), caregiving, or clinical diagnosis. Know the guiding principles: advocacy, autonomy, beneficence, confidentiality, cultural humility, continuity, accountability, evidence-based practice, and stewardship of resources. Commonly described models include brokerage (referral-focused), collaborative or interdisciplinary team, strengths-based, chronic care, patient-centered medical home, transitional care, and managed-care or insurance-based models. The model affects who is accountable and how intensity is assigned.
Traps
Questions often confuse case management with "doing for" the patient. The case manager facilitates informed choice; the patient decides. Another trap is choosing a placement or resource action before assessment. If the stem asks for the first step and the patient is stable, the answer is usually engagement and assessment, not discharge planning. Safety exceptions include imminent harm, suspected abuse, or acute deterioration, which require immediate escalation.
Worked example
A patient with repeated admissions says, "I just can't manage my pills." A weak answer is "arrange a pillbox." A stronger answer is to assess health literacy, regimen complexity, cost, side effects, and caregiver support, then co-create a plan and verify understanding with teach-back. That is patient-centered case management in action.
Rule of thumb
When two answers are clinically plausible, choose the one that preserves patient autonomy and is explicitly supported by an assessment.