Q&A: The relationship between the case management director and vice president

Q. What do you think about “dotted line” relationships between the case management director and other departments and vice presidents?

A. Dotted lines on an organizational chart indicate informal reporting relationships, as compared to “solid lines,” which indicate a formal reporting relationship. No matter where the solid and dotted lines go, case management directors and staff members are always working in a “web” of lines. Case management exists to create a matrix at or near the patient care level, meaning that the processes of nurses and social workers bring together resources to meet patient and family needs. For a case manager or social worker to have the authority to procure resources internally and externally, the director must also have the authority to expect cooperation from internal and external suppliers of the resources. Case management can’t have the entire world of resources reporting to it, so dotted lines are essential.

For more information, see Case Management Models: Best Practices for Health Systems and ACOs, Second Edition.

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