V1SAGES 2

The purpose of this project was to describe a harmonized model of case management based on the evaluation of case management programs deployed in six facilities of Saguenay-Lac-St-Jean regional health authority (CIUSSS) in order to improve these programs while creating new case management  knowledge that could be useful in other contexts.

Case management programs help improve the integration of care and services. The skills, leadership and experience of the case manager, providers’ access to the individualized service plan (ISP), the consideration of patient and family members’ needs and their participation in decision-making, and the provision of self-management support have an impact on integrated care and health service utilization.

The study highlights the importance of tailoring the trajectory and the intensity of intervention to the degree of complexity of the patients. A harmonized model of case management (logic model) was developed by the research team in close collaboration with decision makers. Collaboration  allows decision-makers to gain a better understanding of the causal links between the context of the case management program, the resources dedicated to it, the activities of the actors involved, and the expected outcomes for both patients and the healthcare system. Thus, informed changes can be made, supporting continuous improvement.