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The emergency department case manager: effect on selected outcomes
Laurie J Gautney1, Marietta P Stanton, Carolyn Crowe
1Baptist Health System of Alabama, PO Box 830605, Birmingham, AL 35283, USA. Laurie.Gautney@bhsala.com
Summary
Implementing nursing case managers (NCMs) in the emergency department (ED) improved patient care and reduced costs. This study shows NCMs enhance appropriate admissions and satisfaction, demonstrating their value in hospital settings.
Area of Science:
- Healthcare Management
- Nursing Administration
- Quality Improvement
Background:
- Emergency departments (EDs) face challenges with patient flow and resource allocation.
- The role of nursing case managers (NCMs) in optimizing patient care pathways requires further investigation.
- Effective management of admissions and patient satisfaction are critical in acute care settings.
Purpose of the Study:
- To evaluate the impact of assigning nursing case managers (NCMs) within an emergency department (ED).
- To assess NCMs' effects on inappropriate intensive care unit (ICU) admissions, hospital admission precertification, ICU diversion rates, cost savings, and staff/patient satisfaction.
Main Methods:
- A pretest and posttest design was employed over one year in a 534-bed urban acute care teaching facility.
- Nursing case managers (NCMs) were integrated into the ED 7 days a week.
- Data collected included variables related to admissions, diversion rates, costs, and satisfaction.
Main Results:
- Analysis of data before and after NCM implementation is pending.
- The study aims to quantify improvements in admission appropriateness and cost-efficiency.
- Staff and patient satisfaction levels will be compared pre- and post-NCM assignment.
Conclusions:
- The integration of NCMs in the ED is hypothesized to streamline patient care processes.
- Expected outcomes include reduced inappropriate admissions and enhanced operational efficiency.
- Findings will inform best practices for NCM deployment in emergency care.