Anna Askerud, a School of Nursing lecturer, chose to explore patients’ experiences of nurse case management in primary care. In doing so, she helped set up a nurse-led, long-term conditions programme based around care coordination at Mornington Health Centre, a large primary health care organisation in Dunedin.
The meta-synthesis focused on patients with multiple chronic conditions who had poor health outcomes and were high users of primary and secondary care, as well as social services.
A thematic analysis of data revealed three key themes. Firstly, patients with experience of nurse case management valued the focus on their health and social needs, as well as the long-term relationship and collaborative care that this model provided. Secondly, patients perceived their experiences of nurse case management more favourably than those with General Practitioner (GP) or district nurse care. Finally, there was also the potential for dependence on the nurse case manager. This could result in burnout and professional boundary issues for the health practitioner involved unless support and guidance was provided.
These results support findings from research in the United States and United Kingdom that point to economic and psychological advantages of proactive and effective care coordination. Research also highlights the benefits of ongoing relationships between patients with chronic conditions and health professionals.
As Anna says, “Nurse case managers, who work as part of a supportive multidisciplinary primary care team, can provide highly valued and effective care which can result in an improved quality of life, fewer hospital visits and better health outcomes for those with long-term conditions.”
Askerud, A.M. (2015) Patients’ experiences of nurse case management in primary care: a metasynthesis. Master of Health Sciences Nursing (clinical), University of Otago.