Implementation of nursing case management to improve community access to care: A scoping review

Abstract

Background: Case management is an approach used to help patients locate and manage health resources as well as to enhance effective communication among patients, families, and health systems. Nurses’ role as case managers has been proven effective in reducing healthcare costs among patients with chronic diseases. However, little is known about its implementation in improving access to care in community-based settings. Objectives: This scoping review aimed to examine the components of nursing case management in improving access to care within community settings and to identify the issues of community-based nursing case management for future implications. Design: This study was conducted following the framework of scoping review.Data Sources: The authors systematically searched five electronic databases (CINAHL, PubMed, Science Direct, Scopus, and Google Scholar) for relevant studies published from January 2010 to February 2021. Only original studies involving nurses as one of the professions performing case management roles in the community-based settings, providing 'access to care' as the findings, were included. Review Methods: The article screening was guided by a PRISMA flowchart. Extraction was performed on Google Sheet, and synthesis was conducted from the extraction result.Results: A total of 19 studies were included. Five components of nursing case management to improve access to care were identified: 1) Bridging health systems into the community, 2) Providing the process of care, 3) Delivering individually-tailored health promotion and prevention, 4) Providing assistance in decision making, and 5) Providing holistic support. In addition, three issues of nursing case management were also identified: 1) Regulation ambiguity, 2) High caseloads, and 3) Lack of continuing case management training.Conclusion: Care coordination and care planning were the most frequent components of nursing case management associated with access to care. These findings are substantial to improve nurses' ability in performing the nursing process as well as to intensify nurses’ advocacy competence for future implications.

Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study

“…However, this compassionate, altruistic movement reaches out to the one conducted by the NCM of the present study when they go beyond what is stipulated in their role. In this sense, different studies [ 4 , 77 ] also describe this going beyond the limits in NCM to the care of other population profiles, pointing to a necessary balance between multiple roles (especially those of providing direct care, being a liaison and training others), while, because of overload and this multiplicity of roles, they were forced to extend their working hours. This way of feeling, doing, and going beyond that is shown by nurses and NCM has gained special relevance during COVID-19, as is reflected in the literature [ 57 ].…”

“…Another incentive is that when they can humanize the patient, they increase the emotional and cognitive connection, providing satisfaction in their performance [ 76 ]. One of the biggest incentives for commitment is to be recognized for the results (in all areas of their performance [ 1 , 77 , 80 , 81 ]) and for the care itself by their colleagues (whether or not they are case managers), patients, and relatives [ 59 , 82 ].…”

Community nursing interventions for chronic disease management

“…In cases community nursing interventions play a role by providing personalized care, regular monitoring and supportive assistance to patients. 15 This discussion explores the signs of chronic diseases and emphasizes the significant contribution of community nursing in managing these conditions. For example, diabetes, an illness presents with various symptoms, like frequent urination increased thirst and hunger, fatigue blurred vision and sometimes weight loss.…”

Models Used by Nurse Case Managers in Different Autonomous Communities in Spain: A Scoping Review

“…Case management (CM) is used to promote better coordination of health services and allow greater access to all populations; it optimizes available resources, improves communication between health care professionals, patients, and their families, and improves the quality of care [1,2]. CM is known internationally as a strategy to reduce health costs, and there is now strong evidence that the implementation of CM can reduce hospital use and improve patients' quality of life [3][4][5][6][7].…”

“…Commonly known as NCM, is responsible for case identification, multidimensional assessment, care delivery, and evaluation of the health outcomes of the patient and their family members [14]. The scope of action of the nurse case manager is very broad; including primary care, specialized care, and home care [1,14,15]. For a long time, there has been confusion about the role of NCMs internationally due to constantly changing models of CM, no consensus on its definition, and little theoretical underpinning.…”