Patient Care Management as a Global Nursing Concern

Abstract

Effective and efficient patient management is important in all health care environments because it influences clinical and financial outcomes as well as capacity. Design of care management processes is guided by specific principles. Roles (e.g., case management) and tools (e.g., clinical paths) provide essential foundations while attention to outcomes anchors the process.

Case Manager Role Definitions

“…(CMSA, 2005) The full immersion model of care management was built from concepts found in the case management literature related to role functions of discharge planning, utilization review, and care coordination or facilitation (Huber, 2006;Marquis & Huston, 2003;Powell, 2000). Bower (2004) confirmed that effective and efficient designs of care management processes will be needed, guided by specific principles that include tools, roles, and outcomes in healthcare. In addition, the full immersion model defined specific caseload volumes to be managed by the RN case manager in acute care patient populations.…”

“…Empiric studies of case management typically focus on clinical outcomes; specifically physiological indicators, activity and functionality levels, patient comfort, the absence of complications, and evidence of skills (Bower, 2004;Cudney, 2002;Johnson & Schubring, 1999;Lamb, 1995). Studies of the effectiveness of case management as a care delivery model have focused on the achievement of patientspecific clinical outcomes (Anthony, Brennan, O'Brien, & Suwannaroop, 2004;Cudney, 2002;Dalton, Evans, Wilson, & Roberts, 2007;Dlugacz & Stier, 2005;Lynn & Kelley, 1997;Tonges, 1998).…”

“…Although these are important indicators for any disease-specific case management program, they do not represent indicators that can be readily linked to organizational success. through care facilitation and clinical best practices (Bower, 2004;Cudney, 2002;Fraser & Strang, 2004;Zander, 2004). Anthony et al (2004) examined care delivery model effectiveness.…”

“…Although some authors equate case management with the emergence of managed care, the history of case management outlined by the literature demonstrates that managed care is a business model, whereas case management is a service in which outcomes are the product that can be provided in a variety of settings (Bower, 2004;Zander, 2004). Although some authors equate case management with the emergence of managed care, the history of case management outlined by the literature demonstrates that managed care is a business model, whereas case management is a service in which outcomes are the product that can be provided in a variety of settings (Bower, 2004;Zander, 2004).…”