title: Expanded role of nursing in ambulatory managed care. Part II: Impact on outcomes of costs, quality, provider and patient satisfaction.
abstract: This evaluation project used a triangulation of methods and data sources to link the expanded role nurse clinician (NC) to outcomes of costs, quality, and satisfaction in managed care. Results of patient surveys, case studies, cost-benefit analyses, interviews, focus groups, and HMO documents suggest that the impact of the role has benefit far beyond its costs. This article builds on an earlier article (Nursing Economic$, Vol. 17, No. 1). Part I reviewed literature on expanded role nursing in population management, and described the development of the NC role. In Part II, the NC expanded role is linked to organizational outcomes of costs, quality, and satisfaction. Results here could be used by managers and planners to provide rationale for implementing expanded nursing roles in managed care in order to improve ambulatory care processes, recruit and retain nurses, reduce costs, and increase patient and provider satisfaction.
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* / Q000523:psychology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007587:Job Description; D007588:Job Satisfaction; D008329:Managed Care Programs / Q000458:organization & administration*; D009720:Nurse Clinicians / Q000458:organization & administration* / Q000523:psychology*; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D017060:Patient Satisfaction; D015397:Program Evaluation; D011787:Quality of Health Care; D012456:Salaries and Fringe Benefits