The time has come for a new approach to hospital case management services. To date, most hospitals have adopted some form of the dyad (integrated) or triad (collaborative) model to deliver the major functions of patient care. In the dyad model, the case manager performs utilization management (UM) and discharge planning. In the triad model, one case manager performs UM, another performs discharge planning and a social worker addresses psychosocial issues.

Because of staffing shortages, hospitals have been forced to employ travelers or contract labor, which is expensive, to handle these functions. Consequently, many hospitals no longer can afford to efficiently and effectively provide case management services using either the dyad or triad model. In the real world, most hospitals use hybrid systems, which draw on strategies, methods and practices from both models, often to the detriment of one or more functions within departments.

“Those models are not practical in this day and age,” says Cari O’Leary, RN, and partner in the High Performance Interdisciplinary Rounds. “We want to transform those models by offering a solution we call Dynamic Case Management.”

In brief, Dynamic Case Management takes advantage of offshoring to create an expert clinical team, which operates 24/7 in support of any and all case management functions including, where required, emergency department case management.

Most hospitals are now equipped with technology that allows for remote working. If the coronavirus pandemic has taught the world anything, it’s that remote working often results in increased productivity in shorter timeframes, improved job satisfaction and geographic flexibility. That same infrastructure expands the talent pool of skilled nurses, case management workers and other hospital resources from the local to the global population.

A simple matter of fact is that hiring nurses outside of the U.S. is less costly. More importantly, by implementing the Dynamic Case Management model, a full range of services can be delivered by following the sun, resulting in 24-hour operational coverage.

Think about it: the work done by the case management department does not start when a case manager arrives at the hospital at 7 AM nor does it stop when the case manager leaves at 4 PM. At a typical hospital, the emergency department doesn’t even start warming up until around 11 AM. Peak admission time usually occurs in the late afternoon and early evening. In a normal day, there are not enough hours to get everything done, which means the workload is pushed off to the following day. In the morning, case management staff faces an insurmountable backlog — and the cycle repeats.

“Imagine how much more a team of case managers working 24 hours a day, seven days a week, 365 days a year could accomplish,” says O’Leary.

Another benefit facilitated by Dynamic Case Management is more productive and convenient communication between case managers and the patient’s family or caregiver(s). Regular jobs and personal obligations, particularly child care, often makes scheduling family meetings difficult during the regular workday. With round-the-clock scheduling, case managers can facilitate discussions around patient care in the afternoon or evening, which is not only convenient, but also allows for input from the physician who saw the patient that day.

In O’Leary’s words, “Dynamic Case Management is poised to transform the healthcare industry, leading to financial benefits, operational efficiencies, optimum wellness and better health outcomes across the board.”

To learn more about how Harmony can help your organization transition to Dynamic Case Management, please contact us.

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Dynamic Case Management


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