Patient and staff evaluation of an in-hospital case manager function Authors: Lindegaard BR, Qvist P Objective: To evaluate the effect of introducing a mandatory case manager function in Danish hospitals. Methods: Allocation of a case manager for both in- and outpatients is now a part of the health legislation in Denmark. Case manager allocation is reported quarterly to the Danish regions and results are generally satisfying. Detailed knowledge about fulfilment of the case manager role is however sparse. We examined whether the case manager function in hospital was regarded as a success seen from both patients and staffs perspective. Two medical and two surgical wards participated. Patients were interviewed in relation to discharge while staff assigned as case managers completed a survey. Both patients and case managers answered questions regarding the defined roles of a case manager: Planning and coordination of hospital stay, continuous information and discharge planning. Results: 107 of 125 eligible patients were interviewed.18 patients were excluded – mainly because of mental impairment. All participating patients had a named case manager documented in the records, but only 25 declared themselves informed about the allocation of a named case manager. The patients assessments of the service provided by the staff in relation to case manager tasks were generally good, but the services were seldom provided by the individual case manager. 22% of patients did not experience continuous information, while only 13% did not experience a generally coherent and coordinated stay in hospital. 110 case managers completed the survey. Less than half (41%) felt themselves well informed about the case manager role. Only a few case managers feel that they succeed in fulfilling the role, particularly regarding the participation in discharge planning. Only 16% of case managers consider the possibilities for meeting the requirements as satisfactory. Conclusion: Most patients were unaware of the allocation of a case manager and the case manager tasks were generally carried out by different members of the staff. Staff members assigned to a case manager function were not sufficiently informed about their role. The conditions to fulfil the function were regarded as inadequate by the staff. There seems to be a need for a targeted effort to improve the case manager function in Danish hospitals in order to meet the intentions of this initiative.
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