Barriers in Case Managers’ Roles: A Qualitative Systematic Review

Abstract

The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers' barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.

Case Management Effectiveness on Health Care Utilization Outcomes: A Systematic Review of Reviews

“…The evidence from reviews that dosage, intensity, or duration of CM services was considered in the research was limited. Such dosage information must be connected to patient outcomes for evidence-based CM practice and research (Joo & Huber, 2017). Future intervention studies and systematic reviews should consider intervention type, intensity, duration, and frequency of services with supports of outcomes.…”

“…Chronic illnesses are not cured at once; they need continuous and prolonged care by health care professionals (Joo & Liu, 2017). To reduce health care costs associated with chronic illness care and to increase the quality of that care, many practitioners rely on case management (CM; Joo & Huber, 2017; You, Dunt, Doyle, & Hsueh, 2012).…”

“…CM is “a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes” (Case Management Society of America, 2017). Systematic reviews and meta-analyses have found CM to positively affect objective clinical data and psychosocial outcomes, including in the care of several chronic illnesses (Joo & Huber, 2017). Several systematic reviews have shown that CM improved both medical and psychological conditions (Berthelsen & Kristensson, 2015; Joo & Huber, 2015; You et al, 2012).…”

Reporting and synthesis practices in barriers and facilitators reviews: a methodological systematic review

“…[39] Issues regarding factor identification (e.g. publication bias and context of study) [34,39,[44][45][46][47][48][49][50] "[T]he results of the studies included in our review are already lik to be condensed. Other barriers may have been identified but no reported if the investigators did not feel that they were significan findings."…”

Barriers and facilitators systematic reviews in health: A methodological review and recommendations for reviewers

“…Issues regarding factor identification References 28,40,41,37,[42][43][44][45][46]20,47 When extracting barriers and facilitators, reviewers tend to merge similarly worded factors across studies without considering the context or process through which the individual factors were identified. A number of reviewers reported concerns with the extraction phase, as similar factors identified in different contexts may relate to different issues.…”