2.50
Hdl Handle:
http://hdl.handle.net/10755/166151
Category:
Abstract
Type:
Presentation
Title:
Moving From a CNS to Case Manager Role
Author(s):
Wells, Nancy
Author Details:
Nancy Wells, DNS/DNSc/DSN, Vanderbilt University Medical Center, Nashville, Tennessee, USA, email: nancy.wells@mcmail.vanderbilt.edu
Abstract:
In response to managed care and capitated reimbursement, many hospitals have implemented case management programs. Case managers typically are accountable for patient progress toward identified goals within a specified timeframe. Hospital-based case managers coordinate care for a group of high risk or high volume patients through their hospitalization. While case managers come with a variety of clinical experiences and educational preparation, the Clinical Nurse Specialist (CNS) role contains many of the skills, such as expert clinical knowledge, problem-solving, and collaboration, required for case management. The purpose of this study was to describe the changing roles of the CNS as they move to CNS/Case Manager (CNS/CM) role in an academic medical center. In this pre-posttest design, data were gathered on the CNS role prior to implementation of case management, and one year after implementation of the case management program. CNS/CM activities were grouped into six broad categories: practice (18 items), research (4 items), staff-based education (4 items), School of Nursing education (3 items), consultation (2 items), and administration (5 items). For each item, the respondent identified the amount of time spent in this activity and the importance to their role on 5-point likert scales. Respondents also estimated the actual and desired percent of time spent in each of the six broad categories of CNS/CM activities. A convenience sample of 28 CNS's employed at least 50% by the hospital and clinic completed the questionnaire pre-implementation, and 27 CNS/CM's one year post -implementation. Prior to implementation of case management, the CNS's reported a high degree of importance (>3/5) to most of the practice, research, and education activities, but spent considerable more time in practice activities than research or education. Preliminary data analysis of the post-implementation data suggests this trend has continued, with increased emphasis and time spent in assessment, coordination of care, and case identification after case management implementation. CNS's spent approximately one-third of their time in practice activities pre-implementation, but desired a greater percent of their time devoted to practice. Post-implementation data suggest that the average time in practice has increased for CNS/CM's, which more closely approximates their ideal role. Preliminary analyses of changes over time suggest that the CNS/CM's practicing in this academic medical center have shifted their role to include more patient-focused activities, while reducing the educational activities of the CNS role. Data analysis will be completed by July 1995. These shifts in role are consistent with the case manager job description within the institution and the more consistent with the ideal role of this sample of CNS/CM's.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
Feb 29 - Mar 2, 1996
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleMoving From a CNS to Case Manager Roleen_GB
dc.contributor.authorWells, Nancyen_US
dc.author.detailsNancy Wells, DNS/DNSc/DSN, Vanderbilt University Medical Center, Nashville, Tennessee, USA, email: nancy.wells@mcmail.vanderbilt.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166151-
dc.description.abstractIn response to managed care and capitated reimbursement, many hospitals have implemented case management programs. Case managers typically are accountable for patient progress toward identified goals within a specified timeframe. Hospital-based case managers coordinate care for a group of high risk or high volume patients through their hospitalization. While case managers come with a variety of clinical experiences and educational preparation, the Clinical Nurse Specialist (CNS) role contains many of the skills, such as expert clinical knowledge, problem-solving, and collaboration, required for case management. The purpose of this study was to describe the changing roles of the CNS as they move to CNS/Case Manager (CNS/CM) role in an academic medical center. In this pre-posttest design, data were gathered on the CNS role prior to implementation of case management, and one year after implementation of the case management program. CNS/CM activities were grouped into six broad categories: practice (18 items), research (4 items), staff-based education (4 items), School of Nursing education (3 items), consultation (2 items), and administration (5 items). For each item, the respondent identified the amount of time spent in this activity and the importance to their role on 5-point likert scales. Respondents also estimated the actual and desired percent of time spent in each of the six broad categories of CNS/CM activities. A convenience sample of 28 CNS's employed at least 50% by the hospital and clinic completed the questionnaire pre-implementation, and 27 CNS/CM's one year post -implementation. Prior to implementation of case management, the CNS's reported a high degree of importance (>3/5) to most of the practice, research, and education activities, but spent considerable more time in practice activities than research or education. Preliminary data analysis of the post-implementation data suggests this trend has continued, with increased emphasis and time spent in assessment, coordination of care, and case identification after case management implementation. CNS's spent approximately one-third of their time in practice activities pre-implementation, but desired a greater percent of their time devoted to practice. Post-implementation data suggest that the average time in practice has increased for CNS/CM's, which more closely approximates their ideal role. Preliminary analyses of changes over time suggest that the CNS/CM's practicing in this academic medical center have shifted their role to include more patient-focused activities, while reducing the educational activities of the CNS role. Data analysis will be completed by July 1995. These shifts in role are consistent with the case manager job description within the institution and the more consistent with the ideal role of this sample of CNS/CM's.en_GB
dc.date.available2011-10-27T14:41:15Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:41:15Z-
dc.conference.dateFeb 29 - Mar 2, 1996en_US
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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