Patricia Hinton Walker

Bridging the gap between psychiatric hospitalization and community care: Cost and quality outcomes☆

Abstract Background : Current changes in the health care system require the development of interventions that reduce length of stay and provide alternatives to hospitalization while maintaining quality and consumer satisfaction. Objectives : The objectives were to (a) investigate differences in quality indicators for patients receiving case management services; (b) measure satisfaction of patients enrolled in the case management intervention; and (c) reduce costs related to high utilization of services as a result of recidivism and rehospitalization. Study Design : Inpatients were randomly assigned to either an intervention (n = 121) or control group (n = 122). The intervention group received transitional case management services; the control group received traditional care. Results : No differences were found between the two groups on the Beck Depression Inventory or the Mini-Mental Status Examination. Ninety-six percent of the patients and 95% of their caregivers were very pleased with the case management intervention. Fewer patients in the intervention group (9 vs. 16 in the control group) were readmitted to the hospital over the course of the project. Similarly, only 1 patient in the intervention group versus 18 patients in the control group used the emergency department. Even considering the cost of providing case management services, an overall savings of

Building Community: Developing Skills for Interprofessional Health Professions Education and Relationship-Centered Care

175,375 occurred for the intervention group. Conclusions : Transitional case management services maintained quality and reduced costs with a high level of consumer satisfaction. (J Am Psychiatr Nurses Assoc [1999]. 5, 46–53)

Nursing Informatics: Opportunities for Administrators, Clinicians, Educators, and Researchers

In 1995, the National League for Nursing commissioned a Panel on Interdisciplinary/Transdisciplinary Education. The focus of the Panels work was to examine educational issues that transcend the health professions and to make recommendations for future implementation of an interdisciplinary approach to addressing them. This article is being simultaneously published by several professional journals. The goal is to seek as much feedback as possible.

The University of Rochester experience.

Nursing informatics combines computer science, information science, and nursing science into a new specialty that offers opportunities and challenges for all nurses. In the information age, nurses will need to build their knowledge and skills to famil iarize themselves with the technology, resources such as the Internet, and software for databases, spreadsheets, projects, and graphics. Nurses must be able to partici pate actively when institutions choose information systems so that nursings inter ests will be considered. (J AM PSYCHIATR NURSES Assoc [1995]. 1, 22-29)

On Nursing Theories and Evidence

To establish a school-based health center, it is more important than ever to plan for financial support for building a practice. It is difficult to get to and stay at the target enrollment for this population since it is ever-changing group of students. Plan for increased numbers of initial assessments since every year at least one-fourth of the enrollees in the program change. Work closely with primary care providers and make it clear in verbal and written communication that there is no intent to disrupt the relationship with the student. Assess risk of the population and attempt to predict utilization of services (number and type of encounters) and determine costs of care. It is also important to find ways to track hospitalizations, emergency room visits and other unscheduled access to care. Since adolescents frequently seek confidential care, parents and providers may be uninformed regarding the actual cost of management of covered lives in a managed care environment.