To help assess the changing nature of case management, Heidi Stevens has produced a research protocol, ‘The effectiveness of a case management approach to care for adults who suffer trauma through injury: protocol for a systematic review’. Here, she discusses her aims and ambitions for the protocol, which is set to be released later this month.
What is your background and what are you doing currently?
I am an associate public health nutritionist and have just started working on a systematic review for Teesside University investigating weight management interventions for people with severe mental health issues.
Heidi Stevens
What inspired you to create this research protocol?
The systematic review was commissioned by CMSUK to research available evidence on case management for injuries and was part of an MSc public health at the University of York. I thought it would be a good opportunity to produce a dissertation that would be of value to the research community rather than just as part of a module.
What were your impressions/understanding of the role of case management prior to undertaking your study?
Case management is complex and I soon found that even within the case management community there is debate as to what it entails and how to describe it.
There are also contrasting opinions regarding synonyms for case management. So, it took me a while and a lot of research before I understood the basis for it.
How long did your protocol take to complete and was it a full-time project?
I completed the masters full-time alongside paid part-time work.
The protocol took approximately two months to develop and altogether the review took around eight months.
It was very labour intensive due to the high volume of documentation. In addition, as case management is so complex I mapped out each study intervention which also took some time.
It was not a case of, for example, drug A versus drug B which may have been a little more straightforward.
You note the lack of reviews into case management in the case of traumatic injuries – was this a barrier to your work?
A lack of quality primary studies was certainly a barrier to producing a result regarding the effectiveness of case management. However, a lack of data also opens up the potential for recommendations which of course allows other researchers to address the gaps in evidence.
How receptive have case managers been?
CMSUK has been tremendous. Before I started the protocol for the review, I had multiple meetings with practicing case managers who provided me with insight into the role.
So rather than learn from text only, I gained some first-hand knowledge.
A few case managers also wrote accounts of a typical working day (‘a day in the life of a case manager’). I have also been in constant contact with the society chair, Sue Ford throughout the research.
In addition, Sue Lukersmith in Australia also kindly gave up some time to explain how the CMTaxonomy can be applied to describing models of case management. I later used the CMTaxonomy to map out the case management interventions in my review which really helped to structure the vast amount of data that I had extracted.
What do you think should happen next?
Obviously, I am new to this area. However, I do think more collaboration between case management societies, researchers, patients and other stakeholders would be key to establishing a common, accepted description of case management. It would make research a lot more effective.
Additionally, a set of agreed, standard outcome measures for case management interventions would promote consistency in evaluations
