Of all the recent changes in health care, none have more dramatically affected both patients and care providers than managed care. Not only has it altered the way we pay for health care but also it has compelled a change in the way we approach health care, focusing increasingly on preventive care to reduce costs. In Managed Care , Dr. Margaret M. Conger and her colleagues examine the impact of managed care on nursing as a profession and nurses as individual caregivers. Organized into three sections, Managed Care looks at the nature of managed care, nursing strategies in acute care hospitals, and nursing strategies in community settings. Section I examines the evolution of managed care, definitions, and issues informing this method of service delivery, and nursing involvement in quality of care and case management. In Section II, the authors look at acute care settings, discussing the use of nurse extenders, advanced practice nursing, case management, automated clinical pathways, and outcome research. Section III addresses the community settings and explores case management, advanced practice roles in community health clinics, and collaboration in primary care settings.
Managed Care will serve as an excellent course text on nursing and managed care, as well as being a useful introduction and shelf reference for professional nurses at all levels.
Inhoudsopgave
PART ONE: MANAGED CARE ENVIRONMENT
PREFACE: INTRODUCTION TO MANAGED CARE STRATEGIES
Health Care Reform – Margaret M Conger and Jo Anne Woodall
An Opportunity for Nursing
Managed Care Organizational Structures – Margaret M Conger
Managed Care Organizational Strategies Used to Achieve Organizational Goals – Margaret M Conger
Nursing Involvement in Quality of Care Issues – Margaret M Conger
Nursing Case Management – Margaret M Conger
A Managed Care Organizational Strategy
PART TWO: NURSING STRATEGIES IN ACUTE-CARE HOSPITALS
Use of Nurse Extenders – Margaret M Conger
Advanced Practice Nurses – Margaret M Conger
Acute Care Settings
Nurse Case Management – Margaret M Conger and Jo Anne Woodall
Acute-Care Hospital Practice
Automated Clinical Pathways in the Patient Record – Lisa Brugh
Legal Implications
Clinical Pathway Outcome Research – Pamela Keberlein
PART THREE: NURSING STRATEGIES IN COMMUNITY SETTINGS
Nurse Case Management in Community Settings – Margaret M Conger
Population-Based Nurse Case Management – Margaret M Conger
Advanced Practice Nurses as Case Managers – Margaret M Conger and Carol E Craig
Advanced Practice Roles in Community Settings – Carol E Craig, Kathy Ingleses and Margaret M Conger
Community Health Clinics
Advanced Nurse Collaborative Practice in a Primary Care Setting – Carol E Craig and Margaret M Conger
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