Case Management

CMW tip of the week: Worst case management structure

Case Management Weekly, December 16, 2009

Editor’s note: This week’s tip is a Q&A that appears in Hospital Case Management Models: Evidence for Connecting the Boardroom to the Bedside published by HCPro, Inc. For more information about this book or to order it visit the HCMarketplace.

Q: What is the weakest/worst case scenario for the structure of a case management department?

A: The weakest structure for hospital case management, representing a “perfect storm” of several difficult situations at once, is a combination of the following:
  • No director, and a manager buried (organizationally) under a director of an obscure department that was assigned case management during a restructure for downsizing 
  • Case managers who report to unit nurse managers with a dotted line to the case management manager. (This structure does not provide hospitals the central, knowledgeable engine necessary to drive goals. Nurse managers also are unable to focus on case management, and case managers are often pulled into staffing)
  • No social workers anywhere in the hospital, except perhaps in maternity/pediatrics
Have a tip or tool you’d like to share, or maybe a question for our experts? E-mail it to editor Ben Amirault at Your comments or ideas could appear in a future issue of Case Management Weekly.

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