Introduction
Case management for the long-term mentally ill is pro-
posed as a means of achieving ‘an integrated and continu-
ous service built around individual needs’ (Shepherd
1990). Together with needs assessment, case management
was identified as a cornerstone of community care in the
key government policy document (Secretaries of State for
Heath 1989). Despite its popularity as a concept, it seems
far from clear what case management is (Bachrach 1988),
and even less clear what case managers do. The general
aims and principles of case management have been broadly
agreed (Intagliata 1982) to enhance the continuity of care
and its accessibility, accountability and efficiency. In addi-
tion, the core functions of case management have been
identified as: assessment of client need, development of a
comprehensive service plan, arrangement of service deliv-
ery, monitoring and assessment of the services provided
and evaluation and follow-up (Clifford & Craig 1988).
Many outcome studies have been published in the USA
and, more recently, in the UK, which attempt to demon-
strate the efficacy of case management interventions. Early
reviews highlighted the paucity of methodologically sound
studies (Chamberlain & Rapp 1991). Burns & Santos
(1995), reviewed the literature on randomized controlled
trials of case management between 1990 and 1994 and
concluded that (p. 669):
Strong positive effects of assertive community treatment
(case management) on hospital days and on patient and
family satisfaction were found.
Journal of Psychiatric and Mental Health Nursing, 1997, 4, 287–294
© 1997 Blackwell Science Ltd 287
Case management: a week in the life of a clinical case
management team
A. WAITE
1
BS c( H ons), J. CARSON
2
BA ( H ons), MS c, C . P sychol, D. CULLEN
3
BA ( H ons),
N. OLIVER
4
MA , F. HOLLOWAY
5
MA , MB , FRCP sych and K. MISSENDEN
6
BA ( H ons)
1
Clinical Psychologist in Training, University College, London, UK,
2
Senior Lecturer in Clinical Psychology, Institute
of Psychiatry, London, UK,
3
Clinical Psychologist in Training, The University of East London, London, UK,
4
The
University of East London, London, UK,
5
Consultant Psychiatrist, The Bethlem and Maudsley NHS Trust, London,
UK and
6
Clinical Psychologist in Training, The University of East London, London, UK
WAITE A., CARSON J., CULLEN D., OLIVER N., HOLLOWAY F. & MISSENDEN K.
(1997) Journal of Psychiatric and Mental Health Nursing 4, 287–294
Case management: a week in the life of a clinical case management team
This paper describes the work of a clinical case management core team (four nurses and an
occupational therapist) during the course of a week. Information was gathered through
non-participant observation of the team by two independent researchers. Transcripts pro-
duced from the data recorded were examined. From this, seven categories of activity were
identified: planned client contact; unplanned client contact; family/carer contact; liaison;
administration; team information sharing and supervision, training and personal develop-
ment. These categories were felt to encompass the range of activities practised by the team.
The amount of time that case managers spent engaged in these core functions was calcu-
lated. Detailed examples are presented. Results are discussed with reference to Kanter’s
components and principles of clinical case management.
Keywords: activity analysis, case management, continuing care, Kanter’s model qualitative
methods, time management
Accepted for publication: 14 January 1997
Correspondence:
Jerome Carson
Senior Lecturer in Clinical
Psychology
Institute of Psychiatry
De Crespigny Park
Denmark Hill
London SE5 8AF
UK
E-mail: JeromeCar@aol.com