Improving care with nurse case managers: practical aspects of designing lipid clinics.
Compliance with the National Cholesterol Education Program (NCEP II) Adult Treatment Panel II guidelines for lipid management in patients with coronary artery disease has not been widespread. Barriers to effective lipid management occur at numerous levels of interaction between the patient, provider, and healthcare organizations. Nurse care managers (NCMs), recognized in the inpatient and discharge planning settings, are emerging in new roles in the outpatient setting working in subspecialty areas including lipid/risk-reduction, heart failure, and anticoagulation clinics. To improve patient adherence to NCEP II goals, NCMs can help overcome treatment barriers by: (1) bridging inpatient/outpatient care; (2) securing long-term patient compliance and follow-up; (3) developing clinic policy and computerized patient databases; (4) implementing management algorithms; and (5) enhancing financial reimbursement from insurers. Additional graduate nursing programs and novel healthcare delivery models demonstrating the ability to overcome the barriers to improved patient care must be encouraged and supported.
Thomas
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Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill 27599-7075, USA.
D000553:Ambulatory Care; D019090:Case Management; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology / Q000628:therapy*; D009720:Nurse Clinicians; D010353:Patient Education as Topic; D011787:Quality of Health Care / Q000458:organization & administration*