Nurse case management: collaborative beyond the hospital walls

Area of Science:

• Community Health Nursing
• Healthcare Management
• Patient Advocacy

Background:

• St. Joseph Medical Center established a nursing case management program in 1989.
• Initially serving frail elderly patients, the program has expanded its scope and patient base.

Observation:

• The program now employs five registered nurses managing over 120 patients.
• Target populations include frail elderly, high-risk pregnant women, premature infants, AIDS patients, and individuals with chronic conditions.

Findings:

• Nursing case management intervention led to a 71% decrease in medical center admissions.
• A 21% reduction in length of stay and a 64% decrease in Emergency Room usage were observed.
• The program effectively manages and coordinates patient care across all settings, acting as a patient advocate and broker of services.

Implications:

• Nursing case management prevents health problems from escalating, leading to more efficient resource utilization.
• This approach achieves improved patient outcomes while requiring fewer, less costly resources.
• The model demonstrates the value of proactive, coordinated care in managing complex patient populations.