Whose patient is it anyway? Coordinating nursing and case management services.
This article discussed ways for nurses and case managers to address the challenges of providing care to medically complex patients. By focusing on early identification of patient needs, appropriate referrals can be made by nursing personnel to case management. Nurses are able to impact the outcomes of the patients on a daily basis. However, time and resource constraints often leave nurses with limited ability to provide discharge and follow-up services necessary for complex medical patients. Ideally, nursing and case management can work together to address the entire continuum of care needed by these complex patients. Recognizing how and when to integrate these two professionals in caring for specific types of patients can be challenging. The case studies presented in this article should assist the reader in identifying role expectations and potential patient outcomes. The reader is encouraged to share these case studies with others in the organization struggling to develop and/or integrate nursing and case management services in a seamless process. By recognizing and supporting each other, nursing personnel and case management staff are able to become the advocates that patients need and deserve in order to obtain optimal care.
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Augusta Medical Center, 78 Medical Center Drive, Fishersville, VA 22939, USA.
Hinegardner
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Rea
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Reed
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Ward
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D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000458:organization & administration*; D003152:Community Health Nursing / Q000458:organization & administration; D003153:Community Health Services / Q000458:organization & administration; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D005260:Female; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D024802:Nurse's Role; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning / Q000458:organization & administration*; D010351:Patient Discharge; D010353:Patient Education as Topic; D024382:Professional Role; D012017:Referral and Consultation