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Nurse case manager effectiveness and case load in a large clinical practice: implications for workforce development.

C Wilson1, J Curtis, S Lipke

  • 1Division of Centers of Excellence, Phoenix Indian Medical Center, Phoenix, AZ 85016, USA.

Diabetic Medicine : a Journal of the British Diabetic Association
|July 20, 2005
PubMed
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Nurse case management improved adherence to diabetes care and glucose control in American Indian and Alaska Native patients. A team of four nurses managed 365 patients each, demonstrating effective diabetes care delivery.

Area of Science:

  • Public Health
  • Diabetes Management
  • Healthcare Interventions

Background:

  • Effective diabetes management strategies are crucial for diverse patient populations.
  • Nurse case management (NCM) is a key intervention for improving health outcomes.
  • There is a need to define NCM elements and develop a skilled workforce for the growing diabetic population.

Purpose of the Study:

  • To assess the effectiveness of NCM in an American Indian and Alaska Native population.
  • To quantify the caseload required for effective NCM.
  • To identify critical elements of NCM for diabetes care.

Main Methods:

  • Retrospective cohort study design.
  • Comparison of outcomes between patients receiving and not receiving NCM.

Related Experiment Videos

  • Analysis of adherence to diabetes services and glycemic control (HbA1c).
  • Caseload calculation for a team of four nurse case managers.

    • Main Results:

    • Patients with NCM showed significantly higher rates of eye exams, dietitian consultations, self-blood glucose monitoring, dental exams, foot exams, and nephropathy screening.
    • NCM was associated with a greater reduction in HbA1c levels (-0.52 vs. -0.17 units) after adjustments.
    • Effective NCM was achieved with an average caseload of one nurse case manager per 365 patients.

    Conclusions:

    • NCM is effective in improving adherence to diabetes care services in this population.
    • NCM positively impacts short-term glycemic control trends.
    • A dedicated NCM team can successfully manage a substantial patient load, improving diabetes care outcomes.