title: Expanded role of nursing in ambulatory managed care. Part I: Literature, role development, and justification.
abstract: New expanded roles in nursing are developing in response to the health system switch from private, episodic care of individuals to health maintenance organizations (HMO's) focusing on disease prevention and promotion of health for populations of persons with chronic illness. This evaluation project explored the role of the nurse clinician in population and case management at a large HMO in the Northwest United States. In Part I of this two-part series, a literature review, is presented on chronic illness, ambulatory nursing, expanded role nursing, and nursing in HMOs. The development of the expanded role nurse clinician at the managed care organization is also described. Results could be used by HMOs to attract and retain nurses, improve care processes, and decrease costs in ambulatory care.
authors.affiliation: University of Washington, School of Nursing, Seattle, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Schroeder
authors.forename: B
authors.initials: B
authors.lastname: Trehearne
authors.forename: D
authors.initials: D
authors.lastname: Ward
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D019090:Case Management / Q000458:organization & administration; D002983:Clinical Competence; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D007587:Job Description; D015205:Northwestern United States; D009720:Nurse Clinicians / Q000458:organization & administration*; D009732:Nursing Care / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D010043:Outcome and Process Assessment, Health Care