The clinical nurse specialist as case manager in a collaborative practice model: bridging the gap between quality and cost of care.

The status of the current health care environment demands that health care providers deliver quality health care while reducing health care costs. While the nursing profession is faced with the critical issue of providing quality cost-effective care, the clinical nurse specialist (CNS) is caught in a controversy created by cost containment efforts and the nursing shortage. To provide effective yet efficient care mandates that patient care be comprehensive and integrated. This article presents a model of delivery of care that proposes the utilization of the CNS in a collaborative model of practice based upon case management. The operationalization of the model is based upon the interweaving of the role dimensions of the CNS, the goals of case management, and the components of collaborative practice into patient care.