Overcoming Obstacles in Case Management: Best Practices and Insights

By Kelly McGill, RN, MSN

Kelly McGill serves as the Director of Clinical Operations for Brundage Workforce Solutions. She leverages over a decade of case management experience to support internal teams and clients. Her role focuses on clinical guidance, strategic collaboration, and delivering tailored solutions to meet client needs.

Acute care case managers face numerous challenges in ensuring patients receive optimal care and effective discharge planning. Many challenges are interconnected, often compounding one another, making it critical to approach them with a strategic mindset.

5 Challenges in Case Management

In the complex healthcare landscape, case managers play a pivotal role in ensuring seamless patient care transitions, particularly as patients prepare for discharge from the hospital. These professionals juggle multiple responsibilities, including patient advocacy and resource management, to navigate the intricacies of care coordination.

Below, we explore five key challenges faced by case managers, specifically discharge planners in acute care settings, along with practical solutions to address them effectively.

Managing Complex Patient Needs with Limited Resources

Studies from the Journal of the American Medical Association reveal that nearly half of Medicare beneficiaries have at least three chronic conditions, making them more medically complex patients. Coordinating care for these patients requires collaboration among various specialists—physical therapists, hospitalists, dietitians, pharmacists, and behavioral health providers, among others.

Coupled with staffing shortages, budget constraints, and limited availability of post-acute services, case managers often struggle to deliver optimal care and discharge planning.

• Identify high-risk patients early during their hospital stay to allocate resources effectively and strategize care plans.
• Conduct daily interdisciplinary rounds led by case managers to facilitate discharge planning and ensure comprehensive care.
• Collaborate with insurance providers’ case managers to enhance resource availability and ensure tailored discharge plans.
• Implement a complex case manager model, assigning experienced social workers or case managers to handle the most challenging cases.
• Educate case management teams on up-to-date guidelines and resources, empowering them to provide holistic, informed care.

Addressing challenges in case management requires interdisciplinary collaboration, adaptable workflows, and supportive technology to streamline communication and resource allocation. By prioritizing education, team support, and proactive problem-solving, case managers can improve outcomes for patients and families alike.