Defining the “value-added” of advanced practice nurse care coordination for children with complex special health care needs

2.50
Hdl Handle:
http://hdl.handle.net/10755/308070
Category:
Abstract
Type:
Presentation
Title:
Defining the “value-added” of advanced practice nurse care coordination for children with complex special health care needs
Author(s):
Erickson, Mary
Lead Author STTI Affiliation:
Zeta
Author Details:
Mary Erickson, DNP, RN, PNP, mary.erickson@childrensmn.org
Abstract:

Session presented on: Sunday, November 17, 2013

Background: Children with complex special health care needs (CCSHCN) require high levels of health care services from multiple providers across systems of care.  The costs of care for these children are approximately three times higher, with more service utilization and more costs per capita than children in the general population. There is increasing evidence that care coordination in a health care home model can improve functional outcomes and decrease utilization of hospitalizations and emergency department (ED) visits for children with special health care needs (CSHCN). Despite this evidence, established guidelines for education, experience, or competencies of care coordinators in the health care home model or documented strategies for integrating this role does not exist.

Methods: TeleFamilies is a three-armed randomized controlled trial (NIH R01NR010883) testing the effectiveness of a full-time Pediatric Nurse Practitioner (APRN) telehealth care coordinator for CCSHCN. Interactions between APRN and families of CCSHCN are conducted by telephone or video telehealth. Exceptions include interactions during pediatric clinic visits, hospitalizations and school visits. A telehealth nursing encounter form is completed after each contact and documents the person(s) involved, activities completed and encounter outcome. Patterns of utilization are analyzed by cohort for variance in frequency and intensity of service utilization over the 2.5 year enrollment period.

Results: Parents initiated the majority of encounters with most frequent reasons included care coordination, acute and chronic condition management and support.  Almost 15% of APRN telehealth encounters required an advanced scope of practice that prevented a clinic visit. Autonomy of the APRN diminished parent need for multiple team contacts. Unique case examples illustrate the complexity and varied of care coordination encounters for subjects with multiple conditions.

Conclusion: The TeleFamilies APRN care coordinator role illustrates the competencies required for high-complexity care coordination and the potential to manage healthcare utilization with high-quality care.

Keywords:
advanced practice nurse; health care utilization; care coordination
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott
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.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDefining the “value-added” of advanced practice nurse care coordination for children with complex special health care needsen_GB
dc.contributor.authorErickson, Maryen_GB
dc.contributor.departmentZetaen_GB
dc.author.detailsMary Erickson, DNP, RN, PNP, mary.erickson@childrensmn.orgen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308070-
dc.description.abstract<p>Session presented on: Sunday, November 17, 2013</p>Background: Children with complex special health care needs (CCSHCN) require high levels of health care services from multiple providers across systems of care.  The costs of care for these children are approximately three times higher, with more service utilization and more costs per capita than children in the general population. There is increasing evidence that care coordination in a health care home model can improve functional outcomes and decrease utilization of hospitalizations and emergency department (ED) visits for children with special health care needs (CSHCN). Despite this evidence, established guidelines for education, experience, or competencies of care coordinators in the health care home model or documented strategies for integrating this role does not exist. <p>Methods: TeleFamilies is a three-armed randomized controlled trial (NIH R01NR010883) testing the effectiveness of a full-time Pediatric Nurse Practitioner (APRN) telehealth care coordinator for CCSHCN. Interactions between APRN and families of CCSHCN are conducted by telephone or video telehealth. Exceptions include interactions during pediatric clinic visits, hospitalizations and school visits. A telehealth nursing encounter form is completed after each contact and documents the person(s) involved, activities completed and encounter outcome. Patterns of utilization are analyzed by cohort for variance in frequency and intensity of service utilization over the 2.5 year enrollment period. <p>Results: Parents initiated the majority of encounters with most frequent reasons included care coordination, acute and chronic condition management and support.  Almost 15% of APRN telehealth encounters required an advanced scope of practice that prevented a clinic visit. Autonomy of the APRN diminished parent need for multiple team contacts. Unique case examples illustrate the complexity and varied of care coordination encounters for subjects with multiple conditions. <p>Conclusion: The TeleFamilies APRN care coordinator role illustrates the competencies required for high-complexity care coordination and the potential to manage healthcare utilization with high-quality care.en_GB
dc.subjectadvanced practice nurseen_GB
dc.subjecthealth care utilizationen_GB
dc.subjectcare coordinationen_GB
dc.date.available2013-12-19T17:26:28Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:26:28Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
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.en_GB
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