Accrediting bodies such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Commission for the Accreditation of Rehabilitative Facilities (CARF), and the National Committee for Quality Assurance (NCQA) are increasing their focus on the deployment and documentation of quality management activities in behavioral health care. Also, managed care organizations are increasing their focus on cost containment and medical necessity criteria that describes the level, intensity, and duration of patient care services. Accrediting and managed care organizations share similarities in their recommendations to health care facilities and service providers, such as:

Collaborative care by critical paths and case management was first introduced into acute medical-surgical care by a group of visionary nurses at the New England Medical Center Hospital (NEMCH) in 1985.<sup>7 Zander   Managing Outcomes through Collaborative Care: The Application of Care Mapping and Case Management Chicago: American Hospital Publishing (1995). 

Cliquez ici pour aller à la section Références</sup> The Center for Case Management (CCM) successfully implemented case management and critical paths at NEMCH and has influenced significant changes in the health care environment by the development of outcome tools that met the challenge of diagnostic related groups (DRGs) and the soon-to-emerge economic constraints of managed care.

It became apparent that professional caregivers had to “either make the larger system work for the patient or directly experience the patients anger, pain, and complications related to inefficient or ineffective activities”.<sup>7CareMap is a registered trademark of the Center for Case Management. Permission to use the CareMap mark and system must be made directly to the Center for Case Management, Inc.

Cliquez ici pour aller à la section Références</sup> The first-generation tools developed by Zander and Bowers of CCM were case management plans (replacing nursing care plans) and critical paths, which establish timelines for tasks and care. Second-generation tools evolved into CareMaps,^{*CareMap is a registered trademark of the Center for Case Management. Permission to use the CareMap mark and system must be made directly to the Center for Case Management, Inc.} which go one step farther and include outcome statements that were behavioral and measurable. It became obvious that a collaborative case management model and CareMap tools must be adapted for behavioral health patients, and thus in 1987, the work began to develop complementary tools for behavioral health settings that would: