Randomized trial shows the importance of evidence-based practice in care management, indicating improved patient outcomes.
Patient complexity continues to rise due to multimorbidity, co-occurring behavioral health needs, and persistent health-related social needs. Care/case managers (CMs) are pivotal in navigating fragmented systems, advancing health literacy, and reducing preventable utilization. This article describes why research and evidence-based practice (EBP) are essential to modern CM practice; summarizes national quality trends with emphasis on the Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQI-90); and outlines a multisite initiative to reduce potentially avoidable hospitalizations. Practice changes are highlighted including standardized care plans, proactive visit cadence, and 7-day postdischarge follow-up. These initiatives were supported by cross-functional governance, analytics, and Plan-Do-Study-Act (PDSA) improvement cycles. Lessons learned underscore the impacts of behavioral health, social needs, and technology-enabled workflows. The article concludes with recommendations to leverage embedded predictive models and integrated dashboards to demonstrate outcomes and sustain performance.
No takes yet. Share an insight, caveat, or question.
Lisa Simmons-Fields (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: