Efficacy of Case Management in a Military Medical Center

To determine the effects of managed care on a United States Army medical center in Georgia.

The sample consisted of the physician staff, nursing staff, ancillary staff, and nurse case managers working with patient populations that were designated to be case managed.

Three instruments were used in this intervention study, which employed a pre- and post-evaluation design: the Moos Work Environmental Scale, the LaMonica-Oberst Patient Satisfaction Scale, and the Shortell ICU Nurse-Physician Questionnaire communication subscale. Thirteen hypotheses were set forth related to patient satisfaction, nurse-physician communication, and other variables.

There was a high degree of patient satisfaction with the nursing care received. There was poor communication between nurses and physicians at the hospital. None of the dimensions of the work environment explained any of the patients' satisfaction.

The success of case management depends on how it is initially implemented and supported at all levels and how it is allowed to evolve. Defining and redefining the role of the case manager is critical. Institutional backing is requisite to successful implementation of managed care.

Final Report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2009105...