CNS-directed case management. Cost and quality in harmony

Preserving the integrity of high quality care in a financially restricted environment is the primary challenge facing healthcare providers. The critical question is which delivery system will use limited resources most efficiently without jeopardizing quality of care? Case management has been identified as a solution that offers the most promise. The case management model at Sioux Valley Hospital was developed to deal proactively with resource-intensive patients with chronic illnesses who have frequent admissions and who create financial risk for the hospital. The authors describe the fiscal and clinical outcomes of these select patients.