Care management requires a dynamic multidisciplinary approach, and we align our practice with these 6 fundamental areas.
- Client Support: clients need basic information about their disease and ongoing support from family, friends, and communities. We encourage our clients to talk about their illness and use this opportunity to assess for client’s knowledge.
- Care delivery system: healthcare providers need to ensure that clients understand their roles within the care management, up-to-date client’s status are recorded, and that follow-ups are in place. We utilize a centralized electronic health record system where staff chart and updated information is appropriately visible.
- Decision support: Regimens should be study and best practice-guided. We are formulating new practices to improve our care and collaborating with an interprofessional team to adopt what is best for our clients.
- Clinical information systems: a unified reference is available to the care team to consult with when guiding the client’s treatment. We maintain the utilization of healthcare providers and their resources to help us improve our practice as well.
- Organization of health care: a continuous involvement of the healthcare team with one another. We establish relationships with our clients’ providers from the beginning and make necessary contacts, whenever needed, during our services.
- Community: healthcare organizations must form alliances with state and local programs to continue and extend support of client’s care. We’re developing relationships with other state programs and non-profit organizations that will benefit our clients.