What it means
A way of organizing care in which a case manager, often a registered nurse or social worker, plans and links all the services a client needs: in the hospital, at discharge, at home and in the community. The aim is good outcomes, safe transitions and wise use of resources. It is used most for clients with complex or long-term needs.
For the nurse
The case manager arranges equipment, home health, rehab or placement, works with insurance, and makes sure everyone shares one plan. Involve them early when a client's discharge needs look complex.
At a glance
| Spanish | gestión de casos |
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Related terms
referral
Sending a client to another professional, service or agency for care or help that they need.
plan of care
A written plan that lists a client's problems, goals and the nursing actions to reach them.
caregiver
A person who looks after someone who needs help, such as a family member, friend or paid helper.
admission
The process of a client entering a hospital or other care setting to receive care.