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Implementation of an Inpatient Case Management Program in Rural Hospitals
Author(s) -
Bertram Dennis A.,
Thompson Mary Carla,
Giordano Dianne,
Perla Jeanne,
Rosenthal Thomas C.
Publication year - 1996
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/j.1748-0361.1996.tb00773.x
Subject(s) - workload , nursing , autonomy , medicine , case management , administration (probate law) , health care , nurse administrator , medline , political science , management , law , economics
The objective of the study was to identify factors that affected the implementation of an inpatient case management program in rural hospitals. The hospitals studied were from the Western New York Rural Health Care Cooperative. Five of the hospitals implemented the program in 1992. A qualitative evaluation was conducted by analyzing tape‐recorded inter‐views with nurses and chief executive officers to identify obstacles to and facilitators of program implementation. Many obstacles to implementation could be traced to workload and time constraints, physician autonomy concerns, and limited nursing staff and physician participation. Implementation was facilitated foremost by the effort and supportive attitudes of nursing leaders and hospital chief executive officers. This study concluded that it should be possible to successfully implement conceptually sound managed care and case management programs in rural hospitals, but it will require a relatively long period of support, especially from hospital administration and nursing leaders.