The nursing care delivery model used at my current employer is the case management model. According to Marquis and Huston (2017) and Cudney (2018), case managers provide care coordination, cost-effective care recommendations, education, and collaboration through the identification of available resources internally and externally (community) between patients, families, and providers. There are many facets of case management, all advocating for a patients optimal health, across the continuum of care (Kelly, Doucet, & Luke, 2019). That said, working in an integrated care delivery system comprised of several Magnet Level facilities, shared governance is present and successful within the overall organization. In the insurance division where I currently work, we have not implemented a full shared governance structural model to date. We have a strong healthy work culture where our boots on the ground staff highly influence decisions regarding practice, safety, quality improvement, and research. The use of a shared governance model has been related to increased staff empowerment, high job satisfaction, increased retention rates, and improved patient outcomes (Allen-Gilliam et al., 2016). I would utilize the case management model and the shared governance model at St. Louis Medical Center (SLMC) because combined, these models have proven improved patient outcomes while delivering cost-effective care to populations (Allen-Gilliam et al., 2016; Kelly et al., 2019).
The main function of a nurse case manager (NCM) within a case management model is interprofessional collaboration to improve care coordination, patient and provider satisfaction, and patient outcomes. To foster interprofessional collaboration across care teams I would facilitate relationships among various stakeholders through purposeful strategy meetings to communicate common goals of delivering high quality care to patients while leveraging the unique skillsets of various team members. Through these interactions, relationship form and knowledge are shared to come to a place of agreement to carry out impactful outcomes. Permitting and promoting a constant flow of communication for both internal and external stakeholders will increase trust and collaboration among the organization.
This model supports the person-centred nursing (PCN) framework by McCormack and McCance because the PCN Framework is based on relationships. Forming and fostering healthful relationships between patients, their loved ones, and providers and showing respect promotes holistic nursing care and improved quality outcomes (McCormack & McCance, 2017). Implementing this model promotes holistic nursing, provides individualized patient care, empowers shared decision making, and ultimately impacts quality patient care outcomes (Fessele, Yendro, & Mallory, 2014). Most often this model is referred to direct patient care however, the concepts in this model are relatable to nurse leadership roles as person-centered nursing results in positive outcomes for nurses, staff, teams, and organizations (McCormack & McCance, 2017).
Allen-Gilliam, J., Kring, D., Graham, R., Freeman, K., Swain, S., Faircloth, G., & Jenkinson, B. (2016). The impact of shared governance over time in a small community hospital. The Journal of Nursing Administration, 46(5), 257-264. doi:10.1097/NNA.0000000000000340
Cudney, A. E. (2018). Letter to the Editor. Consider Case Management Models in Nursing…Fishman, G. Attending registered nurses: Evolving role perceptions in clinical care teams. Nursing Economic$. 2018:36(1);12-17,22. Nursing Economic$, 36(5), 206251
Fessele, K., Yendro, S., & Mallory, G. (2014). Setting the bar: Developing quality measures and education programs to define evidence-based, patient-centered, high-quality care. Clinical Journal of Oncology Nursing, 18, 7-11. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1097
Kelly, K. J., Doucet, S., & Luke, A. (2019). Exploring the roles, functions, and background of patient navigators and case managers: A scoping review. International Journal of Nursing Studies, 98, 2747. doi:10.1016/j.ijnurstu.2019.05.016
McCormack, B., & McCance, T. (2017). Person-centered practice in nursing and health care. Theory and practice (2nd ed.). Oxford: Wiley Blackwell.
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