Swindle D N, Weyant J L, Mar P S
J Case Manag. 1994 Summer;3(2):51-5.
In 1989, St. Joseph Medical Center initiated a community-based nursing case management program with two nurses providing care to high-risk, chronically ill, frail elderly patients. This program has expanded to five registered nurses actively following over 120 patients. Target populations now served have expanded to include: frail elderly, high-risk pregnant women, premature infants, AIDS patients, and those with chronic physical and mental illness. The nurse manages and coordinates the care for patients through all settings (community and hospital), brokering services, acting as a patient advocate, and giving traditional hands-on care as needed. Outcomes analysis has shown that, after nursing case management intervention, the patients demonstrated a 71% decrease in admissions to the medical center, a 21% decrease in length of stay, and a 64% decrease in Emergency Room usage. Nursing case management helps to prevent patients' health problems from becoming more complex. Consequently, managing their health effectively requires fewer, less costly resources while achieving improved patient outcomes.
1989年，圣约瑟夫医疗中心启动了一项基于社区的护理病例管理项目，由两名护士为高危、慢性病、体弱的老年患者提供护理。该项目已扩展到五名注册护士，积极跟踪120多名患者。现在服务的目标人群已扩大到包括：体弱的老年人、高危孕妇、早产儿、艾滋病患者以及患有慢性身心疾病的人。护士通过所有环境（社区和医院）管理和协调患者护理，促成服务，充当患者代言人，并根据需要提供传统的实际护理。结果分析表明，经过护理病例管理干预后，患者入住医疗中心的次数减少了71%，住院时间缩短了21%，急诊室使用率降低了64%。护理病例管理有助于防止患者的健康问题变得更加复杂。因此，有效管理他们的健康需要更少、成本更低的资源，同时实现改善患者预后的目标。
