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Creating a practice partnership: a clinical application of case management
C M Lucas1, E J Dierks, N Parker
1Patient Care Support Services, Legacy Portland Hospital, Oregon.
Advanced Practice Nursing Quarterly
|October 1, 1995
Summary
A new case management partnership for head and neck surgery patients undergoing free flap reconstruction improved care coordination. This initiative reduced patient recovery time, decreasing hospital length of stay by 25% and costs by 15-20%.
Area of Science:
- Surgical Care
- Health Services Research
- Patient Outcomes
Background:
- Head and neck cancer reconstruction frequently involves free tissue transfers (free flaps).
- Care coordination for these complex patients presents significant challenges from scheduling to discharge.
- Optimizing the patient journey is crucial for improving outcomes and reducing healthcare costs.
Purpose of the Study:
- To develop and implement a team partnership framework using case management principles.
- To enhance care coordination for patients undergoing head and neck free flap reconstruction.
- To evaluate the impact of this partnership on patient recovery, length of stay, and costs.
Main Methods:
- Established a multidisciplinary team partnership focused on care coordination.
- Negotiated practice agreements, integrated into a clinical pathway.
- Utilized pre-printed physician orders, patient teaching materials, and a variance tracking tool.
Main Results:
- A 25% reduction in average length of hospital stay was observed.
- Healthcare costs decreased by 15% to 20% post-implementation.
- Patients experienced quicker recovery times, indicating improved care efficiency.
Conclusions:
- A case management-based team partnership effectively improves care coordination in head and neck free flap reconstruction.
- This model demonstrates significant benefits in reducing patient length of stay and healthcare expenditures.
- The findings support the adoption of integrated care pathways for complex surgical populations.