What's your strategy for using evidence in case management?

1 Define your question

The first step in using evidence in case management is to define your question. What do you want to know or do? What is the problem or issue that you are facing? What are the goals and objectives that you and your client have? By clarifying your question, you can narrow down your search and focus on the most relevant and useful evidence. You can use the PICO framework to help you define your question. PICO stands for Population, Intervention, Comparison, and Outcome. For example, if you want to know how to help a client with chronic pain, your question might be: What is the effectiveness of cognitive-behavioral therapy (CBT) compared to usual care for improving pain and function in adults with chronic pain?

2 Search for evidence

The next step in using evidence in case management is to search for evidence. This involves finding and accessing sources of information that can answer your question. Evidence can take many forms, such as systematic reviews, randomized controlled trials, guidelines, case studies, expert opinions, and client feedback. You can use various databases, websites, journals, books, and networks to find evidence. Examples of online resources for case management evidence include The Cochrane Library, The Campbell Collaboration, The National Guideline Clearinghouse and The Case Management Society of America. The Cochrane Library provides a collection of systematic reviews and other evidence on health and social care topics. The Campbell Collaboration has a similar collection of systematic reviews and other evidence on social welfare, education, crime and justice, and international development topics. The National Guideline Clearinghouse is a database of clinical practice guidelines from various organizations and agencies. Finally, the Case Management Society of America offers standards of practice, education, certification and resources for case managers.

3 Appraise the evidence

The third step in using evidence in case management is to appraise the evidence. This means evaluating the quality, validity, reliability, and relevance of the evidence that you have found to determine its strengths and weaknesses, its applicability and feasibility, and its implications and limitations. You can use different tools and criteria to help you appraise the evidence, such as the Critical Appraisal Skills Programme (CASP), The AGREE II Instrument, or The GRADE Approach. CASP is a set of checklists and questions that help you to assess different types of studies. AGREE II Instrument is a tool that helps you to assess the quality and rigor of clinical practice guidelines. The GRADE Approach is a system that helps you to rate the certainty of evidence and the strength of recommendations based on various factors.

4 Apply the evidence

The final step in using evidence in case management is to apply the evidence. This requires tailoring the evidence to your specific situation and client, as well as communicating the evidence to stakeholders such as family members, health care providers, and community partners. You should explain the benefits and risks, alternatives and options, and uncertainties and gaps of the evidence. Additionally, it is important to involve your client in the decision-making process and respect their autonomy and choices. To help with this process, you can use different tools and strategies such as the Ottawa Decision Support Framework for assessing client decisional needs, the Motivational Interviewing Technique for eliciting motivation for change, and the Plan-Do-Study-Act (PDSA) Cycle for implementing and evaluating changes in your practice based on the evidence.

5 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?