Case management for individuals with complex care needs: Factors assisting and hindering implementation

• DOI: 10.1370/afm.22.s1.5109
• Publication Date: 2023-11-16T19:55:51Z
• Authors: Charlotte Schwarz; Shelley Doucet; Donna Rubenstein; Catherine Hudon; Jennifer Taylor; Vivian Ramsden; Alannah Delahunty...; Olivier Dumont-Sa...; Mathieu Bisson; Alison Luke; Dana Howse; Maud-Christine Ch...; Linda Wilhelm
• Keywords: Telehealth

<h3>Context:</h3> Case management (CM) is an effective intervention for patients with chronic conditions and complex care needs. While CM often leads to positive outcomes, it has rarely been implemented in primary Canada, little known of the factors which promote or hinder implementation. <h3>Objective:</h3> To identify facilitated hindered implementation from perspective nurse case managers, clinic managers providers. <h3>Study Design Analysis:</h3> A secondary analysis qualitative data interviews focus groups conducted throughout PriCARE program (implementation analysis, telehealth sub-study realist evaluation). <h3>Setting:</h3> Primary clinics 4 jurisdictions Canada (New Brunswick, Newfoundland Labrador, Quebec, Nova Scotia). <h3>Population Studied:</h3> Key informants involved clinics: (NCMs); <h3>Intervention:</h3> 12-month including components: patient needs assessment, planning, coordination services, self-management support. This was completed without additional funding. <h3>Outcome Measures:</h3> informant experiences reflections on researcher observations. <h3>Instrument:</h3> Semi-structured participants, as well research team during process. <h3>Results:</h3> Clinic encouraged included a holistic collaborative team-based culture, engaged supportive manager, active involvement providers, dedicated protected time NCMs complete tasks. Lack engagement physicians led low recruitment numbers difficulty completing intervention. who did not have set their schedules integrate duties into regular role struggled carry out program. Difficulty coordinating specialists external services also acted barrier. It difficult NCM's address individuals' mental health due lack access care. <h3>Conclusions:</h3> The findings this study provide insight what worked implementing multi study, areas improvement