Professional Case Management最新文献

Purpose of study: The research study aimed to explore the Tele-ICU clinician's perception about the experience with shift handoff communication (SHC) and to identify the Tele-ICU clinician's challenges during the SHC experience.

Primary practice setting: Tele-ICU center in the Midwest region of the United States.

Methodology and sample: A phenomenological interpretive study was conducted to explore lived experiences of Tele-ICU intensivists during SHC.

Results: Five themes emerged in the research. The following are the themes: variabilities in SHC, discrepancies in information delivered during SHC, preference for standardized SHC, positive and negative attitudes toward SHC, and presence of barriers with SHC.

Implications for case management practice: In the Tele-ICU environment, the intensive care unit (ICU) provider also serves as the care coordinator since care is delivered remotely. At the Tele-ICU center, there was no clear indication that case managers were involved during the night shift in coordinating care, which needed further investigation and understanding. Even in a Tele-ICU environment, concise and impactful communication between the members of the multidisciplinary health care team is crucial. Therefore, there is a need to delineate the role of ICU providers as care coordinators remotely in terms of SHC. Information on how equipped the Tele-ICU providers are in terms of coordinating care in transitioning patients out of the Tele-ICU is limited compared to traditional bedside care where a case manager is available as a member of the multidisciplinary team.

Purpose of study: Caring for children and youth with special health care needs can be overwhelming for families. Higher levels of need often require more extensive and coordinated support. The burden of caring for children with complex health care needs can result in negative effects for parents and caregivers over time, thus increasing the risk of poor physical, emotional, and social well-being. Nursing care coordination is an evidence-based intervention that provides families with guidance and support by delivering safe and effective care. The quality of coordination, however, can profoundly shape families' experiences. The purpose of this study was to explore caregivers' perceptions of nursing care coordination provided by their child's public health plan through the lens of Kristen Swanson's Middle Range Caring Theory.

Primary practice settings: The study was conducted across three counties in Florida.

Methodology and sample: A descriptive qualitative design was used. A total sample of nine caregivers and parents were interviewed. Semistructured interviews were used, and data were analyzed utilizing Colaizzi's interpretive method. Categories, subthemes, and themes were created.

Results: The findings of this study highlighted caregivers' experiences of successes and challenges with their child's nurse care coordinators. The exploration of caregivers' perceptions led to two major themes: Triumphs of Nursing Care Coordination and Pitfalls of Nursing Care Coordination. The two themes produced five subthemes: (a) It Takes a Village, (b) Being my Voice, (c) Third Class Citizen, (d) Being Out of Touch, and (e) Just a Title.

Implications for case management practice: Strengths of care coordination include enhanced access to resources, clear guidance for navigating complex health care systems, and improved understanding of treatment options, all of which help alleviate caregiver strain. While nursing care coordination offers many benefits, challenges with the current infrastructure still exist. Nurses must advocate for policies that alleviate caseload pressures, strengthen continuity of care, and identify barriers like fragmented communication and inadequate staffing. Nurses can foster a sense of support by creating forums where parents and caregivers share experiences, while encouraging decision-makers to stay informed about the challenges these families face.

Purpose of study: This quality improvement project was designed to close a gap in capturing health literacy in adult patients with heart failure discharged from a hospital system. An opportunity existed to investigate if health literacy levels contribute to individuals' social factors and overall health. A priority focus was evident across healthcare organizations to address the social determinants of health (SDOH) for the populations served. Throughout the literature, limited health literacy is associated with higher hospital readmission rates. Pre-implementation data included 2023 heart failure readmission rate (19.02%) and baseline SDOH screenings (9,500) which noted housing, food insecurities, and transportation as greatest needs. There was no prior data analysis of how social factors may have impacted readmissions.

Primary practice settings: Patients with recent hospitalization in Acute Care Hospitals with a known heart failure diagnosis; received health literacy screenings by the Registered Nurse (RN) Transitional Care Managers (TCMs) during their post-hospital discharge follow-up calls.

Methodology and sample: Pre-implementation period began in August 2024. Project launched in November 2024 with RN TCMs conducting assessments using the BRIEF (Health Literacy Screening Tool) during post-hospital discharge calls. Additional follow-up calls were required as the intervention for patients with limited literacy during their 30-day post-hospitalization transition period. Data collection occurred from November 2024 through June 2025.

Results: The 8-month period included 1,543 high-risk hospital discharges, among them 580 patients with heart failure screened for health literacy; 517 patients had adequate health literacy, 44 had marginal health literacy, and 19 had limited health literacy. The intervention of additional follow-up calls for patients with limited health literacy achieved statistical significance in reducing readmissions.

Implications for case management practice: By implementing the BRIEF screening tool within an existing RN TCM workflow, it allowed for RN TCMs to interview patients with important questions during a vulnerable time for patients - transitioning from hospital to home. Expansion of health literacy assessments is vital for patients with any chronic condition, not just heart failure. RN TCMs identify the necessary interventions needed to support their patients and develop care plans. It is especially important to understand the needs specifically for patients with limited health literacy. Care management plays a pivotal role in patient advocacy by providing education and coordinating directly with providers to support patients' journey to better health.

In healthcare, nothing stays the same. This issue's Editorial is about three updates case managers should know about: Traditional Medicare's prior authorizations, Doula benefits in Medicaid, and the Hospital-at-home programs extension.