Aims and objectives. Purpose of this study was to gain knowledge of Nurse Case Managers’ (NCM) experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role. Further to learn about patients’ assignment to the management of the NCMs. Explicitly, to explore critical incidences of interactions between NCM, patients and health care practitioner in discharge planning to understand the factor that contributes to effective collaboration. Background and Purpose. The defined role of Nursing Case Manager (NCM) in many contexts is a patient-centred responsibility for a central task of discharge management of patients with complex physical and social needs. Some studies have indicated that the general impact of the role reduces readmission rates. Given the necessity to work interprofessionally to achieve a safe discharge little is known about how NCMs achieve this collaboratively. Methods. A qualitative case study within a German teaching hospital of NCMs (N=8). Data were collected through semi-structured interviews prompted by a critical incident technique and rigorously analysed through the lenses of sociocultural theory. Results. Consistent object being worked upon was a safe and effective discharge from hospital with a focus on patient advocacy. Significant themes were a self-value or recognition by others of professional expertise, reciprocal value on the capabilities of others thorough relational expertise and negotiation with patients and an identification of case trajectories. Conclusion. More continuity of NCMs’ care and management, clarity of role and transparency to peers, physicians and other professionals would be beneficial in ensuring appropriate referral of complex patients to NCM responsibility. Relevance to clinical practice. Clearer role description and benefit realisation of the NCM could be achieved by interventions that are interprofessional and focus on the tasks that matter from a collaborative perspective. This could lead to refinement of available indicators and policy developments.
Thoma, Jorun E.Waite, Marion A.
Faculty of Health and Life Sciences\Department of Nursing
Year of publication: 2017Date of RADAR deposit: 2017-12-08