Quality, cost-effective psychiatric treatment: A CNS--MD collaborative practice model

Health care reform presents an opportunity to design alternative health care delivery models. Psychiatric clinical nurse specialists and psychiatrists are particularly well positioned to work together as full and equal partners, to complement each other's practice and to provide cost-effective care with improved patient outcomes. In this case study, we show that, with the addition of psychotherapy provided by a CNS, the cost of care for the patient decreased from over $40,000 (average hospital cost only) to less than $4,000 per year. In addition, the patient attained competent self-care and an enhanced quality of life. Characteristics of effective collaboration are described. Replication of this design by psychiatric clinical nurse specialists is recommended.