The Primary Role of Case Management is Coordination of Care
The best answer is B: Case management provides coordination of care to ensure continuity across all healthcare settings and boundaries. 1, 2
Core Definition and Primary Function
The primary goal of case management is to ensure continuity for the patient and family across hospital, home, educational, therapeutic, and other settings through comprehensive coordination of services. 1 This distinguishes case management from other healthcare roles that may focus on single aspects like health promotion, communication, or comfort.
Key Elements That Define Case Management
The American Thoracic Society identifies five essential components of the case manager role: 1
- Assessment of the needs of the patient and family for resources and support 1
- Accessing and development of necessary resources 1
- Coordination of services - the central function 1
- Monitoring and evaluation of service provision and cost 1
- Family advocacy 1
The American Academy of Pediatrics emphasizes that case managers integrate and coordinate input from all physicians and ancillary providers when multiple specialists are involved, facilitating communication between the healthcare team and patients/families to improve coordination of daily care plans. 2
Why Coordination is the Defining Feature
While case managers may possess highly skilled communication methods (option C) and promote patient comfort (option D), these are tools and outcomes rather than the primary role. 1, 2 Communication skills are required competencies for effective case management, but the purpose of these skills is to facilitate coordination. 1
Case management is most effective when a single individual is designated to manage the coordinated care over time, avoiding fragmentation of services. 1, 2 This continuity function cannot be achieved through communication alone or comfort measures—it requires active coordination across multiple providers and settings. 3
Distinguishing Case Management from Health Promotion
Option A (promotes healthy lifestyle) describes health education or preventive care roles, not case management. While case managers may address health needs, their primary function is ensuring that health needs are met through coordinated service delivery, not direct health promotion activities. 1
Clinical Context and Application
Case managers are particularly essential for: 2, 4
- Patients with complex medical and care issues 4
- Medically fragile patients requiring services across multiple settings 1
- Elderly patients with changes in functional status 4
- Patients requiring integration of health and social services 3
The case manager provides clients with continuity, consistency, and coordination of care across all clinical settings and boundaries—a function that directly addresses the fragmentation inherent in modern healthcare systems. 3