All you need to know about Cases and Case Management


Ask any healthcare professional what a “Case” is – you’ll quickly find it’s all about discharge planning for individual patients.

Given a diagnosis, the focus goes to setting goals and objectives for identified problems, carrying out “interventions” and attaining goals and objectives in a timely, efficient and effective manner.  Ask what “Case Managers” do and, well, it’s “Case Management”.

Ask a law enforcement professional what a “Case” is. Here, you will find that it starts with an “incident” and progresses from there to a connect-the-dots initiative where the objective is to identify the person(s) responsible for a crime, collect sufficient evidence to hand over the “Case” to a prosecutor and then close the “Case”.  Ask what a “Case Manager” is and you’ll get a blank stare. In law enforcement, “Case Managers” are called investigators.

How do we make the leap from patients and crimes investigations to calling activity like  MRO (Maintenance, Repair, Overall) on a Blackhawk helicopter “Case Management”.  Here, you are likely to get a blank stare as well if you ask an aircraft maintenance technician what a “Case” is.

It turns out that there is a lot in common between patients, major crimes investigations and aircraft maintenance.  It’s a “focus”, either on a patient, or a crimes case or a complex piece of equipment.

They all require a focus, they all need planning, interventions, decision-making, progress monitoring and periodic assessments. The focus is the “Case”.

Some cases are opened, receive Interventions until the case goals and objectives are met and then, they close.  Not always.

A patient can have a relapse, requiring re-opening of the “Case”, a crime case can be re-opened after being classified as a “Cold Case” for a period of years, helicopters come back in periodically for maintenance, so we can add to our list of terms the concept of “Incident”.  An Incident is simply a clustering of interventions usually over a period of time but sometimes Incidents can overlap time wise.

Moving forward (e.g. are you sure this is going somewhere?), what happens during “Case Management”.

We’ve already introduced the term “Interventions” and these precisely are what happen during Case Management.  Some interventions are planned, others are the result of events, but under most scenarios, you need, at a minimum, to document what was done, when, by whom , sometimes how and  why, as well as indicate how the intervention advanced the state of the Case toward its goals and objectives. Interventions, carried out within an Incident, are what you find in “Case Histories”.

Each intervention contributes toward discharge (patients), toward resolution (crimes), toward readiness (aircraft maintenance).  Within a Case, we need to be able to view data (status), as it was, at the time information became available, on the form versions that were in service at the time. A traditional “audit trail” will not suffice.  Clearly, recording data relating to case interventions is essential and sets the stage for real-time decision making and after-the-fact statistical analysis / data mining.

Almost there. It turns out there are two types of interventions (structured and unstructured).  Structured work is best managed using a methodology called Business Process Management (BPM). Ad hoc (unstructured) work is best managed using Adaptive Case Management (ACM).

Since any Case is likely to require a mix of structured and unstructured interventions, you don’t want to circle your wagons around either BPM or ACM. The prudent course is to manage your cases using BPM and ACM.

What about work beyond healthcare, crimes investigations, and aircraft MRO?  No change in mindset needed.

So long as we are talking about scenarios where there are discrete interventions (not continuous processes), the term Case can be used.

A Case receives Interventions, information goes to the Case History which serves a) as a repository, b) as a source of information for real-time decision-making and c) as a generator of data that can be used for sharing and for analytical purposes.

The following is all you need to know about “Cases” and “Case Management”:  Case, Case Opening, Case Goals/Objectives, Incidents, Interventions, Case Management, Case Closing, Case History.

If you are not currently doing BPM within the framework of a Case, you need to look into ACM and get to where the core focus of your BPM becomes “the Case”.  Uncircle your wagons, team up with the ACM folks and re-circle under the ACM/BPM banner.

The bad guys, “Inn Competence” and “Miss Management”, don’t care about differences between unstructured work and structured work.

About kwkeirstead@civerex.com

Management consultant and process control engineer (MSc EE) with a focus on bridging the gap between operations and strategy in the areas of critical infrastructure protection, connect-the-dots law enforcement investigations, healthcare services delivery, job shop manufacturing and b2b/b2c/b2d transactions. (C) 2010-2017 Karl Walter Keirstead, P. Eng. All rights reserved. The opinions expressed here are those of the author, and are not connected with Jay-Kell Technologies Inc, Civerex Systems Inc. (Canada), Civerex Systems Inc. (USA) or CvX Productions.
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