title: Case management of individuals with long-term conditions by community matrons: report of qualitative findings of a mixed method evaluation.
abstract: OBJECTIVE
  To consider findings from a study that evaluated case management of individuals with long-term conditions (LTCs) by a community matron (CM) service. The paper highlights issues related to the implementation of a new role and the impact this had on the experience of care across hospital and community settings for patients and their carers.
  
  
  BACKGROUND
  The introduction of the role of CM was intended to increase effective management of patients with complex comorbid LTCs through the introduction of case management, thereby reducing unplanned hospital admissions.
  
  
  METHODS
  The overall methodological approach was one of mixed methods. This paper reports the qualitative findings from CMs (n = 15); patients (n = 13); family carers (n = 8); and secondary care staff who interface with the CM service (n = 7). Data were collected between October 2009 and May 2010.
  
  
  RESULTS
  A thematic analysis resulted in the identification of four themes: (1) visibility; (2) interpersonal relationships; (3) leadership; and (4) systems/professional boundaries. Patients enjoyed being seen as a whole and family carers appreciated the coordination aspect of the role. Difficulties arose from the limited understanding of the CM role and from a lack of a shared vision across healthcare professionals concerning the role and its goals.
authors: 1 Senior Lecturer and Pathway Lead for Long-term Conditions, Department of Nursing and Health Studies, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors: Sue
authors: S
authors: Randall
authors: 2 Dean, Faculty of Education, Health and Sciences, University of Derby, Derby, UK.
authors: Guy
authors: G
authors: Daly
authors: 3Honorary Research Fellow, Department of Nursing and Health Studies, Coventry University, Coventry, UK.
authors: Colin
authors: C
authors: Thunhurst
authors: 4Associate Director, Health and Social Care Unit, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors: Natalie
authors: N
authors: Mills
authors: 5Subject Librarian in Nursing, The Academic Liaison Team, Lanchester Library, Coventry University, Coventry, UK.
authors: David A
authors: DA
authors: Guest
authors: 6Research Assistant, Department of Nursing and Health Studies, Coventry University, Coventry, UK.
authors: Annette
authors: A
authors: Barker
mesh_terms: D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D019090:Case Management / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D003152:Community Health Nursing / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D015897:Comorbidity; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D010359:Patient Readmission / Q000639:trends; D017060:Patient Satisfaction; D015397:Program Evaluation; D036301:Qualitative Research; D011787:Quality of Health Care; D011788:Quality of Life; D006113:United Kingdom