Developing and testing a case manager impact profile.

Area of Science:

• Nursing
• Healthcare Management
• Health Services Research

Background:

• Rural nurse case managers play a vital role in hospital settings.
• Measuring their activities and perceived outcomes is essential for service evaluation and improvement.
• Existing instruments may not adequately capture the unique contributions of rural nurse case managers.

Purpose of the Study:

• To develop and test a new instrument, the Nurse Case Manager Impact Profile (NCMIP).
• To measure the specific activities and perceived outcomes of rural nurse case managers in hospitals.
• To assess the validity and reliability of the NCMIP.

Main Methods:

• Development of a 69-item Likert-type questionnaire (NCMIP) with Activity and Outcome scales.
• Content validity established by nursing case management and rural nursing experts.
• Psychometric testing including reliability (internal consistency) and validity (factor analysis) on 302 rural nurse case managers.

Main Results:

• High internal consistency was found for all subscales and the overall scales (alphas ranging from .85 to .93).
• Factor analysis confirmed the five-dimensional Activity scale and two Outcome subscales.
• Factor solutions suggested reconceptualization for three Activity subscales and identified overlapping domains in the Outcome Scale, indicating a need for further refinement.

Conclusions:

• The Nurse Case Manager Impact Profile (NCMIP) demonstrates promising psychometric properties, including high reliability.
• Further development and testing are warranted to refine the instrument, particularly the Outcome Scale.
• The NCMIP can be used cautiously as a tool for assessing rural nurse case manager impact in hospital settings.