Organizational innovation Organizational Innovation and Clinical Outcomes: The Case Manager’s Contribution to Personal Care

Abstract

Introduction. In oncology, the increasing complexity of treatment pathways requires high levels of coordination and continuity of care. In this context, the case manager represents an important organizational innovation that may improve treatment adherence, patient experience, and clinical outcomes while reducing fragmentation and optimizing healthcare resources. Particular relevance is given to proximity-based care, which extends care beyond the hospital through integration with community healthcare services and the active involvement of general practitioners, community nurses, social workers, and other professionals. The aim of this study was to evaluate the role of the case manager in oncology pathways, with particular reference to treatment adherence, continuity of care, resource optimization, clinical outcomes, and the experience of the person receiving care.

Methods. A review of national and international literature on case management models in oncology was conducted. In addition, clinical cases managed during the previous three years at the integrated outpatient clinic of San Donato Hospital in Arezzo were analysed, focusing on treatment adherence, continuity of care, and use of healthcare resources.

Results. The implementation of the case manager role was associated with reduced fragmentation of healthcare services, improved treatment adherence, and greater patient satisfaction. Healthcare resource utilization was also optimized through improved planning and coordination of clinical and care pathways. Personalizing care according to patients’ wishes, choices, and availability supported a sense of security, trust, and respect for both patients and their families or caregivers.

Discussion. The case manager represents a strategic lever for organizational innovation by integrating clinical, managerial, and relational competencies within person-centred oncology care. Care should not be understood as the sum of individual services, but as the development of coordinated pathways centred on the person. Strengthening transitions between hospital and community settings may improve patients’ quality of life while reducing the emotional and social burden associated with cancer.