CHCCSM004

CO-ORDINATE COMPLEX CASE REQUIREMENTS

Short Answer Questions

KEY 2 LEARNING COLLEGE

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Assessment 1: Short Answer Questions

Instructions
You will be provided with the assessment via email or hard copy which will be provided by your
trainer/assessor.

Complete all questions and answers before submitting for marking by the trainer/assessor.

If you have any queries, please speak to your trainer/assessor, who will be pleased to help.

When completing this assessment, you will need to answer all the questions which are listed below.

Your response to each question must be detailed and where possible workplace examples should be
provided to demonstrate how you have applied the knowledge in a work context.

If you are not currently employed, examples of how you would apply this knowledge in a workplace
situation is required.

All responses to these questions must be in your own words.

Questions

1. Define each of the following terms which are used in a community service environment
and provide two (2) examples for each.

Terminology Definition Examples

Co-existing needs Someone having one condition Brain injury, Autism spectrum disorders,
or illness at the time multiple mental health condition.

Case Management It is a collaborative process of Assistance with health needs and

Assessment assessment, planning, assistance with transportation.
facilitation, care coordination,
evaluation and advocacy for
options and services to meet an
individual’s and family’s
comprehensive health needs
through communication and
available resources to promote
patient safety, quality of care,
and cost effective outcomes.

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 Terminology Definition Examples
Duel Diagnosis It is the condition of suffering A mental health problem or disorder
from a mental illness and a leading to or associated with
comorbid substance abuse problematic alcohol or other drug use
problem. and a substance use disorder leading to
or associated with a mental diagnosis

2. Provide an overview for each approach to assessment, which are used in case
management:
o Needs-based assessment
o Domain-based assessment
o Norm-based assessment
o Competency based assessment
 Needs-based assessment
It is the process used by organizations to determine priorities, make organizational improvements
or allocate resources.

 Domain-based assessment
A domain based assessment stipulates different areas that impact on individuals ability to manage
areas in their life like mental health, health education

 Norm-based assessment
This assessment let the researcher to compare a person’s level of functioning or other
characteristics against other people in their particular situation or age group.

 Competency based assessment

It is the process of collecting evidence and making judgements about whether a person has
achieved competency.

3. As part of evidence based practice requirements, what are six (6) major areas which
need to be covered in an assessment interview?

Areas to be covered in assessment interview are

1. Ask the burning clinical question
Ans. Inquiries in this format take into account patient population of interest (P), intervention
or area of interest (I), comparison intervention or group (C), outcome (O), and time (T). The
PICOT format provides an efficient framework for searching electronic databases, one
designed to retrieve only those articles relevant to the clinical question. Using the case
scenario on rapid response teams as an example, the way to frame a question about
whether use of such teams would result in positive outcomes would be: “In acute care
hospitals (patient population), how does having a rapid response team (intervention) com-
pared with not having a response team (comparison) affect the number of cardiac arrests

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 (outcome) during a three-month period (time)?”

2. Collect the most relevant and best evidence.

Ans. To collect for evidence to inform clinical practice is tremendously streamlined when
questions are asked in PICOT format. If the nurse in the rapid response scenario had
simply typed “What is the impact of having a rapid response team?” into the search field of
the database, the result would have been hundreds of abstracts, most of them irrelevant.
Using the PICOT format helps to identify key words or phrases that, when entered suc-
cessively and then combined, expedite the location of relevant articles in massive research
databases such as MEDLINE or CINAHL. For the PICOT question on rapid response
teams, the first key phrase to be entered into the database would be acute care hospitals, a
common subject that will most likely result in thousands of citations and abstracts. The
second term to be searched would be rapid response team, followed by cardiac arrests and
the remaining terms in the PICOT question. The last step of the search is to combine the
results of the searches for each of the terms.

3. Critically appraise the evidence you gather.

Ans. Once articles are selected for review, they must be rapidly appraised to determine
which are most relevant, valid, reliable, and applicable to the clinical question. These
studies are the “keeper studies.” One reason clinicians worry that they don't have time to
implement EBP is that many have been taught a laborious critiquing process, including the
use of numerous questions designed to reveal every element of a study.
Rapid critical appraisal uses three important questions to evaluate a study's worth.
• Are the results of the study valid? This question of study validity centres on whether the
research methods are rigorous enough to render findings as close to the truth as possible.
For example, did the researchers randomly assign subjects to treatment or control groups
and ensure that they shared key characteristics prior to treatment? Were valid and reliable -
instruments used to measure key outcomes?

• What are the results and are they important? For intervention studies, this question of
study reliability addresses whether the intervention worked, its impact on outcomes, and
the likelihood of obtaining similar results in the clinicians' own practice settings. For
qualitative studies, this includes assessing whether the research approach fits the purpose
of the study, along with evaluating other aspects of the research such as whether the
results can be confirmed.

• Will the results help me care for my patients? This question of study applicability covers
clinical considerations such as whether subjects in the study are similar to one's own pa-
tients, whether benefits outweigh risks, feasibility and cost-effectiveness, and patient values
and preferences.

4. Integrate the evidence.

Ans. Research evidence alone is not sufficient to justify a change in practice. Clinical
expertise, based on patient assessments, laboratory data, and data from outcomes man-
agement programs, as well as patients' preferences and values are important components
of EBP. There is no magic formula for how to weigh each of these elements;
implementation of EBP is highly influenced by institutional and clinical variables. For ex-
ample, say there's a strong body of evidence showing reduced incidence of depression in
burn patients if they receive eight sessions of cognitive-behavioral therapy prior to hospital

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 discharge. You want your patients to have this therapy and so do they. But budget
constraints at your hospital prevent hiring a therapist to offer the treatment. This resource
deficit hinders implementation of EBP.

5. Evaluate the practice decision or change.

Ans. After implementing EBP, it's important to monitor and evaluate any changes in
outcomes so that positive effects can be supported and negative ones remedied. Just
because an intervention was effective in a rigorously controlled trial doesn't mean it will
work exactly the same way in the clinical setting. Monitoring the effect of an EBP change on
health care quality and outcomes can help clinician’s spot flaws in implementation and
identify more precisely which patients are most likely to benefit. When results differ from
those reported in the research literature, monitoring can help determine why.

6. Share the results with others.

Ans. Clinicians can achieve wonderful outcomes for their patients through EBP, but they
often fail to share their experiences with colleagues and their own or other health care
organizations. This leads to needless duplication of effort, and perpetuates clinical
approaches that are not evidence based. Among ways to disseminate successful initiatives
are EBP rounds in your institution, presentations at local, regional, and national
conferences, and reports in peer-reviewed journals, professional newsletters, and publica-
tions for general audiences.

When health care organizations adopt EBP as the standard for clinical decision making, the
steps outlined in this article naturally fall into place. The next article in our series will feature
a staff nurse on a medical–surgical unit who approached her hospital's EBP mentor to learn
how to formulate a clinical question about rapid response teams in PICOT format.

4. Based on your location, identify and provide a detailed list of local services and support
which are available to clients within your workplace (if not employed this can be based
on your work placement location). Minimum of (8) to be provided.
Ans. The list of local services and support which are available to clients in my workplace are:

1. as far as possible, to have any risks to your health and safety properly controlled
2. to be provided with any personal protective and safety equipment free of charge
3. to stop work and leave your work area, without being disciplined if you have reasonable
concerns about your safety
4. to tell your employer about any health and safety concerns you have
5. not to be disciplined if you contact the Health and Safety Executive for Northern Ireland
(HSENI), or your local authority, if your employer won't listen to your concerns
6. to have rest breaks during the working day
7. to have time off from work during the working week
8. to have annual paid holiday

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 5. Describe four (4) issues which may be faced by clients and their families when trying to
access multiple services to address their needs.

Ans. The four Issues which may be faced by clients and their families when trying to access
multiple services to address their needs are given below:
1. Disempowerment: Many clients’ lives are full of appointments for therapies and services, with
little time or opportunity for recreation. Often their complex issues reduce their quality of life
(QOL) and they may be worn out trying to cope. Clients may feel that they have little control over
their lives. Multiple staff coming into their home to provide services can lead to feelings of invasion
of privacy.
Working with the aim of empowerment is important. At all times, respect must be shown to the
client. Case coordinators and staff should ensure they do not work in an authoritarian manner,
which will further disempower the client.
2. Implications for family and unpaid carers: The presence of support staff in the home may be an
issue. Additionally, much of the focus of the family may be on the client’s needs, such as attending
appointments, leaving little time for family activities, or for other members of the family to have their
needs met. Case coordinators can help clients’ families to address these issues by informing them
about support services. For example, a family may be able to access respite services, must be
careful not to blur the boundaries of their role, remembering that their primary focus is to coordinate
the case requirements of the client.
3. Intensive family preservation services for families that have experienced child maltreatment may
delay child placement for many families in the short term, but there is little evidence to date that the
services resolve the underlying family dysfunction that precipitated the crisis or improve the child's
well-being or the family's functioning. Service providers do not have an effective screening method
to determine which children or families who have been reported for maltreatment would benefit
from intensive services designed to prevent child placement.
4. Although a parent's use of social networks to support family functioning can be influenced
through interventions, there is not enough evidence to indicate whether changes in social networks
can create changes in parenting practices that endure over time and result in reduced child
maltreatment rates. The evidence, although intriguing, does not yet provide clear indications as to
which types of families are most likely to benefit from parental education and family support
services as opposed to mental health services designed to address depression, lack of empathy,
and impulsive behaviour in both parents and children.

6. Discuss the implications which can result from service duplication when addressing
client needs (100 words)

Ans. Unless an effective monitoring system is implemented, service duplication may not be
revealed for some time. Many staff work in clients’ homes, and in other locations in which they are
not directly supervised by their line managers. Sometimes staff act outside of established rules or
client plans. Staff may misunderstand or forget to consult the client plan. They need to be
monitored to make sure everything is running smoothly, and that staff are sticking to the roles and
actions in the client plan.
Some of the Practices to prevent service duplication that is to seek regular client feedback. Monitor
service delivery through documentation. Establish written and verbal reporting mechanisms for staff
who work in clients’ homes to provide regular reports of the duties they are undertaking. Manage
unsatisfactory staff performance by following organizational procedures for counselling, retraining

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 and monitoring employees who do not follow care plans. Conduct regular review meetings. Liaise
regularly with all organizations involved in the client’s service delivery.

7. Explain how the six principles/practices of working across multiple services as part of
your role are applied as part of your role and workplace. (if not employed this can be
based on your work placement location)

Principles/practices of working Outline

across multiple services
1. Client centred service
The focus of the reforms in Victoria is to move to client
centred service delivery. The introduction of an
individualised client package is being viewed as a key
mechanism to drive these reforms.
Use it with staff to assist in developing a shared
understanding of where your organisation is at and what
you might need to do.
A simple step by step guide developed (and tested) by
HACC services in the Department of Health, Eastern
Metropolitan Region to create an individual plan to move
the organisation towards client centred practice.

2. Recognising diversity
Recognizing, valuing, and taking into account people's
varied cultures, knowledge, talents, and perspectives, as
well as promoting and using those distinctions to create a
cohesive and efficient workforce, is what diversity is all
about. Everyone profits from diversity, and that should be a
part of everything we do.

3. Collaboration
Although the skills mentioned above will help you
collaborate efficiently, it's not just about what you do; it's
also about how you do it. The mentality with which you
handle teamwork will make all the difference. Hold these
principles at the back of your mind the next time you need
to work with your colleagues.Principale of efficyive
collaboration are Efficiency, Trust, Empathy, Positivity,
Clarity etc.

4. Participation
Employee engagement in management decision-making in
the workplace, either in relation to broader business
problems (workplace social dialogue) or in their immediate

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 Principles/practices of working Outline
across multiple services
employment, is referred to as interest at work (task
discretion).

5. Accountability
The most successful businesses have systems and
processes where employees can reference a project’s
schedule and tasks so they have a clear understanding of
how their contributions affect the group. That way if
deadlines are missed or someone isn’t pulling their weight,
it can be addressed quickly. In the workplace, responsibility
ensures that everyone is accountable for their acts,
attitudes, results, and decisions. It's also related to a raise
in employee commitment and productivity, which
contributes to improved outcomes.

6. Holistic Approach
An interconnected (holistic) perspective of the method, or in
our case, the organisation, is referred to as a holistic
approach. The properties of a system cannot be determined
purely by the properties of its elements.
As a consequence, we look at the enterprise as a whole,
not just its subsystems (parts). The emergence theory is in
place. The phenomena that occur at the subsystem level do
not correspond to the phenomena that occur at the system
level.

8. Research and list three (3) types of funding arrangements available to the community
service sector and provide an overview (50 words) the purpose for each.

Funding type Overview

1. NDIS
The Universal Disability Insurance Scheme (NDIS) is a
modern way of offering personalised assistance to people
with disabilities, their relatives, and carers. The NDIS' main
aim is to provide all Australians under 65 who acquire a
long-term disability that substantially restricts their ability to
perform everyday activities with the adequate and required
care they need to live a normal life.

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 Funding type Overview

2. Brighter Futures Better Results, Brighter Prospects is the first overarching

national action strategy for children and young people (aged
0-24 years), established and led on behalf of the
government by the Minister for Children and Youth Affairs.

3. Child, Youth and Family

Support (CYFS)
Kid, Youth, and Family Service (CYFS) is an early
intervention network for infants, youth, and their families. It
offers a wide variety of programs to vulnerable infants,
teenagers, and households who do not meet the
requirements for statutory child protection action.

9. Outline six (6) signs you need to be aware of which may indicate that a client is in
danger of self-harm or harm to others.

10. Explain the obligations that you and your organisation has regarding the referral of
clients. Provide an example of when this would be necessary. Include the steps which
need to be taken to meet these obligations.
Obligations: The definition of an obligation is something that someone is required to do. An
example of obligation is for a student to turn in his homework on time every day. An obligating or
being obligated.

Steps:
Step 1: Identify the contract with a customer
Step 2: Identify the performance obligations in the contract
Step 3: Determine the transaction price
Step 4: Allocate the transaction price to the performance obligations in the contract
Step 5: Recognize revenue when (or as) the entity satisfies a performance obligation

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 11. Provide a bullet point process which should be followed when conducting a formal
meeting with a client and relevant services to assist with meeting specific needs.

 Set objectives: A clear objective will encourage people to attend the meeting because they
will understand its intent. It also will set the foundation for a focused meeting.
 Assemble attendees: Create a list of who needs to attend this meeting. Think carefully
about whether or not someone needs to be in the room for the duration of the meeting
(perhaps they can join you via conference call, or for one specific topic).
 Create an agenda: It can be something you use for yourself or hand out at the meeting.
The upside of handing out an agenda is that it provides a script for people to follow. If you
need to resolve other issues first you may want to keep the agenda to yourself. If you are
running a status meeting you can use your project timeline as your agenda.
 Maintain control: Once the meeting has begun, it is your responsibility to keep it moving
and keep it focused.
 Follow up: Once the meeting has ended, you still have work to do. Put together and
distribute an action list summarising what was covered, what was resolved, and what
actions need to be taken for issues requiring further clarification. This should come straight
from the meeting notes.

12. Complete the table by outlining the key risks and responsibilities specific to your duty of
care when dealing with the following issues:
 children and young people:
 domestic violence:
 Suicide:
 elder abuse

Issues Risks Duty of care responsibilities

Children and young Poor social skills: Emotional self-regulation
people communication and problem- Good coping skills and problem-solving
solving skills, Low self-esteem skills. Engagement and connections in
Shyness two or more of the following contexts:
school, with peers, in athletics,
employment, religion, culture
Domestic violence High friendship quality
Depression and suicide attempts Social support (for example, tangible
Anger and hostility help, support from neighbours).
Lack of nonviolent social Neighbourhood collective efficacy.
problem-solving skills Coordination of resources and services
Antisocial personality traits and among community agencies
conduct problems
Poor behavioural
control/impulsiveness

Suicide The risk of the person Family supports and experiences that
committing suicide in the first appear to reduce risks for suicide, and

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 Issues Risks Duty of care responsibilities
year after an episode of are equally important in the assessment
Self-harm is up to 100 times of risk. Support from ongoing medical
greater than the general and mental health care relationships.
population risk. The more skills in coping and problem solving,
serious the level of suicidal conflict resolution, and non-violent ways
intent at the time of self-harm, of handling disputes
the greater the risk of
Subsequent suicide.

Elder abuse Social isolation of caregivers Report suspicion of abuse or risk of

and older persons, and the abuse to their supervisor. It is important
ensuing lack of social support, is to gather as much relevant evidence as
possible and to document this by
a significant risk factor for elder
making clear notes. Your service may
abuse by caregivers. have service coordination tools you
should use.

13. Identify a minimum of eight (8) effects, both short and long-term, that generational
abuse can have on an individual.
Ans.
1. Child Mal-treatment effect
2. Issues Of Stigma, Bias, And Discrimination
3. Issues Of Stigma, Bias, And Discrimination effect
4. Cognitive and Intellectual effect
5. Psychosocial effect
6. Psychosocial effect
7.Domestic violence effect
8.Alcohol problem

14. Discuss seven (7) common effects welfare dependency can have on an individual and
need to be understood when working in a community service environment.

15. Based on your workplace or work placement location, outline the documentation
protocols you need to adhere to when managing client cases and sensitive information.
(100 words). Include (6) examples of the types of documentation which needs to be
maintained.

16. List three (3) different issues which could cause client confusion, concern or barriers
when providing assistance. Outline the process you would implement to address each

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 issue.

Issue Process
1.

2.

3.

17. In 100 words, explain the difference between an interagency meeting and a case
conference. In your answer, you must outline the purpose of each and the process that
should be adhered to.

18. Explain the principles and practices which need to be followed when planning complex
service inputs and ensure that you cover the following points: (300 words)
 Definition of complex needs
 Techniques for identifying needs
 Consideration for prioritising needs
 Working with culturally diverse clients and Aboriginal and Torres Strait Islander
people.

19. Provide an overview for each of the following regulatory standards, legislations and
statutory mandates which need to be followed when working in community service
roles.

Legal requirement Overview

Mandatory Reporting

Human Service Framework

(in your state or territory)

Working with Children

The Privacy Act 1988

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 Legal requirement Overview

20. Complete the table by outlining the key aspects of four (4) different family structures
and the dynamics of each
Explaining the term “family dynamics”

21. For each of the following cultures, provide:

 A brief history for each (key characteristics)
 Cultural considerations which need to be factored when providing a service
 Linguistic needs which may need to be addressed to minimise any barriers

Nationality History Cultural Linguistic needs if

Considerations applicable
Italian

Chinese

Aboriginal
and/or Torres
Strait Islander

22. Provide a brief summary of the issues that a client, their family and carers may face
when working with multiple services. Include in your answer consideration of family
structure, dynamics, communication and decision-making.

23. There are a number of different models of case management that different
organisations employ. These include:
 Strength based
 Direct service/intensive
 Co-ordination/generalist
 Advocacy
Outline the similarities and differences between each model then decide on and
explain which form would be most suitable when working with a client who has
complex needs. (100 – 150 words)

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 Strength based:

Co-ordination / Generalist:

Advocacy:

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