Realigning the Communication Paradigm in Nursing Case Management

Abstract

Communication underlies all of case management (CM), and better comprehension of the processes of communication within the context of the CM role may facilitate positive patient and organizational outcomes, and assist providers and policy makers in designing effective CM systems. Thus, the purpose of this qualitative, pilot project was to explore dimensions of communication of the nurse case manager role within a hospital setting. The results describe a "hub and spoke" model of communications and suggest the utility of this familiar model for understanding the communication dynamics for those who work as nursing case managers in hospital settings. Findings suggest that nurse case managers are at various times both advocates and mediators--communications roles that may encompass somewhat contradictory demands and perspectives.

Care Transitions

“…Nurses should understand what information the client needs before, during, or after a transition, recognize when clients are approaching a transition point and assess their preparation and readiness, and understand their role and responsibilities in preparing the client and sharing information.. [37][38][39][40] To improve the coordination of care by the interprofessional team and promote continuity of care on transition, the literature proposes that nurses must develop effective collaboration and communication skills. 41,42 Research question 4…”

Ethical Dilemmas Among Nurses as They Transition to Hospital Case Management

“…As a result of feeling unprepared and powerless in the face of ethical concerns, these hospital nurse case managers may not be able to resolve their feelings of ethical conflict (Anderson et al, 2004;Beilman, Sowell, Knox, & Phillips, 1998;Cooper et al, 2002Cooper et al, , 2004Meaney, 2001;Wetle, 1992). To deflect these emotions, the nurse case manager may resort to behaviors that adversely affect patient care outcomes.…”

“…Better alternatives for care may not be included in the payer's plan. The best referral source for patients may also be hampered by other factors that are beyond the nurse case manager's control, such as institutional policies, treatment modalities, available community resources and the patient's entitlement to their use, institution's interest in cost-effective controls and quality of care, multiple role responsibilities, discrepancies in patients' and nurses' personal and professional values, culture, and religious beliefs (Allred et al, 1995;Anderson, Helms, & Kelly, 2004;Cooper et al, 2002Cooper et al, , 2004Corley, 1995;Jameton, 1993;Mullahy, 1995;Theis, 1986;Wilkinson, 1985Wilkinson, , 1989Wilkinson, , 1993.…”

“…The tensions are created by the differences in organizational, individual, and professional goals (Anderson et al, 2004;Badzek, Mitchell, Marra, & Bower, 1998). Professionals such as administrators and clinicians struggle to find ways to operationalize organizational goals without violating personal, professional values and beliefs and conflicts with one another.…”

A communication intervention for nursing staff in chronic care

“…Despite a growing body of literature indicating that effective communication influences nursing care, quality of life and social well-being (Nagy 2001), many studies have confirmed that communication problems are common in clinical practice (Anderson et al 2004, Shattell 2004. Communication skills training has been extensively cited as a means to remedy these problems, yet nurses' interactional skills have not improved over time (Chant et al 2002).…”