While multiple recent studies have provided evidence of the benefits of case management, primary care teams have struggled to implement and sustain its use in their clinical practices. In this systematic review, researchers examine barriers to case management, as well as factors facilitating its implementation. Researchers conducted a comprehensive literature review of studies that address comprehensive case management from a primary care perspective. A thematic analysis revealed nine barriers and/or facilitators that emerge across different studies, representing the perspectives of diverse health care professionals across six countries. The nine categories are family context; policy and available resources; physician buy-in and understanding of the case manager role; relationship building; team communication practices; autonomy of case manager; training in technology; relationships with patients; and time pressure and workload. Moreover, the framework situates these barriers and facilitators relative to each other. The authors believe their results may be of interest to policymakers, health care professionals and researchers who may use this study as a starting point for further investigation.
Understanding Barriers to and Facilitators of Case Management in Primary Care: A Systematic Review and Thematic Synthesis
Catherine Hudon, MSc, MD, PhD, et al
University of Sherbrooke, Faculty of Medicine, Department of Family Medicine, Sherbrooke, Quebec, Canada