Collaboration for Improving Outcomes- Role and Function

Collaboration for Improving Outcomes- Role and Function
Description: The baccalaureate graduate nurse will contribute the unique nursing perspective to interprofessional teams to optimize patient outcomes.
Course Competencies: 1) Assess the roles of the nurse case manager in the contemporary health care structure. 3) Examine the role of case management in end of life care including ethical and legal issues.
QSEN Competencies: 1) Patient-Centered Care 2) Teamwork and Collaboration 3) Evidence- Based Practice
BSN Essential VI
Area Gold Mastery Silver Proficient Bronze Acceptable Acceptable Mastery not Demonstrated
Roles and Functions Explains the roles and functions of the nurse case manager in each acute care, home care, and primary care settings Discusses the roles and functions of the nurse case manager in each acute care, home care, and primary care settings or explains two of

the three functions

Lists the roles and functions of the nurse case manager in acute care, home care, and primary care settings or explains one of the three functions Does not address the topic
Details Skills Fully details the skills a nurse would need to better prepare to do a community

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health plan for a patient.

Discusses the skills a nurse would need to better prepare to do a community

health plan for a patient.

Lists the skills a nurse would need to better prepare to do a community

health plan for a patient.

Does not address the topic
Details Approaches Fully details the approaches case managers use to promote the highest quality of care with careful use of

resources

Discusses the approaches case managers use to promote the highest quality of care with careful use of

resources

Lists approaches case managers use to promote the highest quality of care with careful use of resources Does not address the topic
APA, Grammar, Spelling, and Punctuation No errors in APA, Spelling, and Punctuation. One to three errors in APA, Spelling, and Punctuation. Four to six errors in APA, Spelling, and Punctuation. Seven or more errors in APA, Spelling, and Punctuation.
References Provides two or more references. Provides two references. Provides one references. Provides no references.

 

Sample Answer

 

Case Management

Roles and Functions of the Nurse Case Manager

The Nurse case manager undertakes the role of coordinating the different aspects of care for patients inside and outside medical facilities. In the acute care setting, the nurse case managers fulfill various roles to facilitate the delivery of care. Firstly, the nurse case manager has the role of managing the use of resources to ensure the optimal utilization of available resources during the provision of care (Campagna & Stanton, 2010). Secondly, the nurse case manager bears the responsibility of coordinating acute care services among the interprofessional team. The nurse case manager oversees the care delivery to ensure that the services are cost-efficient. The nurse case manager carries out the function of managing the patient’s transition to post-acute care services. The next function involves utilizing evidence-based practice protocols to facilitate the delivery of care within the acute care setting. Furthermore, the nurse case manager undertakes discharge planning for acute care patients.

In the home care setting, the nurse case manager coordinates the overall care provided to the patient. In this way, the nurse case manager oversees the interprofessional team that delivers care to the patient. The nurse case manager will endure that the patient receives appropriate care based on the evidence-based care approach. In the home care setting, the nurse case manager carries out the role of communicating with the treating physicians to facilitate the patient’s medical care. The next role is providing the patient and their families to enhance their capacity to make informed care decisions and also participate in the care. The nurse case manager will educate the patient and family on how to follow the care plan. The nurse case manager will take up the function of liaising with health care providers. Moreover, in the home care setting, the nurse case manager fulfills the role of a caregiver, which means they have the responsibility of providing hands-on care to the patient.

In the primary care setting, the nurse case manager coordinates the care within the interprofessional team. Secondly, the nurse case manager undertakes resource management to ensure the optimization of the resources used during the delivery of care (Campagna & Stanton, 2010). The next role involves developing a health plan for the patient. The nurse case manager fulfills the role of utilization review by managing the health care costs through case-by-case assessment. In this sense, the nurse case manager ensures that patients receive cost-efficient care that is reflective of their health plan. Another role within the primary care setting is discharge planning. The nurse case manager carries out an in-depth evaluation to determine whether the patient needs to be discharged or transferred from the current level of care to a different one. Furthermore, the nurse case manager can also fulfill caregiving responsibilities in the primary care setting.

Skills to Develop a Community Health Plan

The first skill that a nurse is required to possess to aid their preparation to do a community health plan is data collection. The nurse undertakes the data collection through various patient assessment techniques such as diagnostic study, health history review, interview with the patient, and thorough physical assessment. The data collection skill enables the nurse to gather all the relevant information before developing the community health plan (Vera, 2020). The second skill required of the nurse is data analysis and interpretation. After collecting information about the patient’s health, the nurse needs to cluster and analyze the information. The nurse is expected to have the right knowledge and skills to interpret the information and utilize the findings in developing the community health plan for the patient. Analysis and interpretation of the collected data will also enable the nurse in identifying related or risk factors that will influence the development of the community health plan.

Nurses are required to have the skill of planning and organization when developing the patient’s community health plan. Firstly, the nurse needs to possess the ability to ability to make plans base on the available information and desired outcomes. The planning and organizational skills are crucial when setting priorities related to the patient’s community health plan. When developing the plans, the nurse needs to utilize their organizational skills to document and organize the components of the community health plan. The next crucial skill for the nurse is goal-setting (Vera, 2020). The nurse is expected to have the ability to establish goals and timelines for the community health plan. The nurse needs to have the ability to make short-term and long-term goals in the plan. Goal-setting skills are crucial when establishing the desired outcomes and objectives of the community health plan. Furthermore, nurses are required to have exceptional communication skills. The communication skills enable the nurse to engage with the patient to understand client goals. The nurse will also communicate the community health plan to the patient.

Resource Management

The first approach utilized by case managers to promote the highest quality of care with careful use of resources is the simplification of the care process. One of the reasons for the ballooning costs of care is the increasing complexity of the care process (Courage, 2011). Therefore, to minimize the cost of health care and to ensure that the patients receive high quality, nurse case manager simplify the care process by eliminating some processes that they will deem unnecessary or through the aggregation of various processes into one process. In this way, the case manager eliminates any duplication of functions while eliminating costly and inefficient processes. The nurse case manager will achieve this by carrying out a thorough assessment of the clinical care process.

The nurse case manager promotes the highest quality of care with careful use of resources through resource monitoring and management. The case manager carries out resource monitoring by undertaking a review of how the available resources are utilized across the processes of care delivery. The main techniques of resource monitoring are consumption management and auditing (Heydari, Najar & Bakhshi, 2015). The case manager will undertake consumption monitoring to determine how and which resources are used by the various health care processes. The auditing process enables the case manager to determine how effectively and efficiently the various care services utilize the available resources. Consumption management and auditing allow the case manager to impose prudent use of resources to achieve cost-efficiency in resource use.

Case managers also apply the resource allocation approach to promote the highest quality of care with careful use of resources. Resource allocation encompasses the processes of identifying and allocating available resources to different care processes (Heydari, Najar & Bakhshi, 2015). The case manager needs to know which resources are available and the scope of utilization of the resources, including duration, number of processes and personnel. During resource allocation, the case manager will allocate resources to different processes to ensure that the processes are assigned resources optimally and efficiently. Through resource allocation, case managers can eliminate wastage of resources by preventing over-allocation of resources.

 

 

References

Campagna, V., & Stanton, M. P. (2010). Case Managers Can Improve Hospital Resource Management. Nurse Leader8(5), 40-43.

Courage, S. (2011). Case management: a strategy for resource management. Journal for Healthcare Quality19(5), 13-21.

Heydari, A., Najar, A. V., & Bakhshi, M. (2015). Resource management among intensive care nurses: An ethnographic study. Materia socio-medica27(6), 390.

Vera, M. (2020). Nursing Care Plans (NCP): Ultimate Guide and Database. https://nurseslabs.com/nursing-care-plans/

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