Give outcomes managers responsibility for continuum-of-care issues.

To ease the burden on already-overworked case managers, some hospitals are shifting responsibility for continuum-focused care to a new breed of outcomes managers. Some experts say it's too much to expect case managers to be able to effectively manage individual cases in the acute care setting and maintain a broader focus on preadmission and postacute care as well. One model involves assigning one outcomes manager to each specific patient population identified as having high volume and high risk. Outcomes managers are drawn from the ranks of clinical nurse specialists and nurse educators. While case managers focus on the needs of individual patients and on discharge planning, outcomes managers focus on the entire service line. In another model, outcomes managers head up population-based work teams in partnership with physicians. Case managers serve on the teams as well and maintain responsibility for data collection. Outcomes managers analyze the data and present results to the work team to determine possible process improvements.