When clinicians at a public mental health service in Victoria decide to commence a period of integrated and coordinated care for a person, this is recorded by opening a case on the Client Management Interface/Operational Data Store (CMI/ODS).
The concept of a case is used for a range of reporting requirements, including caseload analysis and consumer outcome measurement.
Definition of a case
A case is a clinically determined period of care that involves individual service planning and clinical review, generally within a framework of multidisciplinary care.
When people receive bed-based services, a case is automatically opened on the CMI/ODS, if one does not already exist.
Hierarchy of organisational structures
CMI/ODS uses this hierarchy of organisational structures:
A case tracks and monitors coordinated, integrated care across the whole campus of an area mental health service, and incorporates episodes of care in inpatient, community, residential and ambulatory services.
The critical pathway for consumers commences with access to the public mental health system and continues until discharge.
The clinical pathway involves decision points along the way.
Triage is a screening assessment to decide whether to proceed with more comprehensive (intake) assessment and service provision or referral to other services.
Intake (including registration)
If the decision is made to provide clinical services then the consumer is registered on the CMI/ODS information system and issued with a Mental Health Statewide Unit Record number.
A case is automatically opened on the CMI for people admitted to a bed-based service.
For non-admitted clients, it is a clinical decision to commence a case, rather than an automatic part of consumer registration.
The clinical decision to commence a case is based on whether the person requires a period of integrated multidisciplinary care incorporating service planning, monitoring and review, discharge planning and closure.
This would include clients of mobile and support teams (MST), continuing care teams (CCT), Intensive Mobile Youth Outreach Support (IMYOS) and aged persons assessment teams (APAT).
A case may also need to be opened for some clients of a acute community intervention service (ACIS) where they are not already in an open case.
A case is not typically required:
- where contact with clinical services may be brief or one off, such as assessment only
- for discrete specialist clinical services such as consultation and liaison (CL) or emergency department crisis teams (ECATT)
- for shared care arrangements where the primary responsibility for the care is with a designated provider outside the AMHS, for example people accessing a clozapine-only program or secondary consults provided by primary mental health, who are principally under the care of private psychiatrists or general practitioners.
The case is closed when the clinical decision is taken to discharge the person. A new case for the person can be commenced at a later time if necessary.
Case closure on the CMI/ODS is not automatic and needs to be instigated as part of local protocols, for example as a result of clinical review meetings.