Implementation of the case management and interdisciplinary approach in an innovative integrated services delivery in France

Purpose: The 2008–2012 French Alzheimer plan is marked by the experimental implementation of “Homes for Integration and Autonomy for Alzheimer patients” with implementation of intensive case management process for people in complex situation. In 17 experimental sites, teams of case managers (CMs) have been implemented with a total of 67 case managers for performing an intensive case management. Methods: We conducted a qualitative study to develop a full understanding concerning the implementation of the case management process and the links with the interdisciplinary approach. Focus groups were conducted in 2010 to explore the perceptions of case managers six months after their recruitment. Results: Interdisciplinary approach inside the case managers’ team has been rapidly constructed to resolve the complex situations, homogenize practices and help to create the new competency. Multidisciplinary and proximity team, common training and difficulties to get the good fit with professionals increased the interdisciplinary approach inside the case managers’ team. Interdisciplinary approach between case managers and clinical professionals was few implemented because of the high level of fragmentation and lack of case managers legitimacy. Discussion: Implementation of intensive case management in an innovative integrated services delivery showed a stronger interdisciplinary approach between case managers compared to with clinical professionals.