Part Five: Case Management Boot Camp 2026: Fundamentals for Everyday Practice (PT5W6013)-Case Management Boot Camp 2026, Part Five Recording

Video Transcription

Video Summary

Dr. Tony Sesta concluded a multi-week case management series by tying together the major roles, functions, and models used in contemporary hospital case management. She emphasized that case management is not a set of isolated tasks, but an integrated process focused on patient flow, utilization/resource management, denial prevention, discharge and transitional planning, quality improvement, psychosocial assessment, and coordination with the full care team.<br /><br />A major theme was the importance of communication and teamwork. Dr. Sesta explained how RN case managers and social workers complement one another, with RN case managers handling clinical assessment, utilization review, and discharge coordination, while social workers focus on psychosocial needs, crisis intervention, and complex discharge barriers. She also highlighted the value of clerical support staff, ED/admitting case managers, and complex discharge planning specialists in improving efficiency and reducing workload.<br /><br />She reviewed two best-practice case management models: the integrated model, where one RN case manager performs most functions with social work support, and the collaborative model, where utilization management is separated from discharge planning. She compared staffing ratios, daily workflow, documentation expectations, and the advantages and disadvantages of each approach.<br /><br />The session closed with practical guidance on workflow steps, documentation, and staffing questions, including a Q&A on staffing for an emergency department. Overall, Dr. Sesta stressed that effective case management requires evidence-based structure, adequate staffing, strong leadership, and continuous interdisciplinary collaboration to achieve better outcomes and smoother transitions of care.

Keywords

case management

hospital case management

patient flow

utilization management

resource management

denial prevention

discharge planning

transitional care

quality improvement

psychosocial assessment

interdisciplinary collaboration

RN case manager

social worker

integrated model

collaborative model